AI Article Synopsis

  • - A study investigated how microvascular obstruction (MVO) affects left ventricular (LV) diastolic function changes in patients after reperfused acute myocardial infarction (AMI).
  • - Out of 72 patients, 31 had MVO; while LV ejection fraction (EF) improved over 9 months, patients with MVO showed less improvement in diastolic function indicators despite overall LV function improvements.
  • - Key findings indicated that the deceleration time of early mitral inflow and the LV elastance index were more sensitive markers of diastolic function changes than conventional indexes, and these improvements were less prominent in patients with MVO.

Article Abstract

Background: Although left ventricular (LV) diastolic dysfunction is more related to functional capacity after acute myocardial infarction (AMI), the determinants of LV diastolic functional change after reperfused AMI remain unknown. This study aimed to investigate the effects of microvascular obstruction (MVO) on mid-term changes in LV diastolic function after reperfused AMI.

Methods: In a cohort of 72 AMI patients who underwent successful revascularization, echocardiography and cardiovascular magnetic resonance imaging were repeated at 9-month intervals. The late gadolinium enhancement (LGE) amount, segmental extracellular volume fraction, global LV, and left atrial (LA) phasic functions, along with mitral inflow and tissue Doppler measurements, were repeated.

Results: Among the included patients, 31 (43%) patients had MVO. During the 9-month interval, LV ejection fraction (EF) and LV global longitudinal strain (GLS) were significantly improved in accordance with a decrease in LGE amount (from 18.2 to 10.3 g,  < 0.001) and LV mass. The deceleration time (DT) of early mitral inflow (188.6 ms-226.3 ms,  < 0.001) and LV elastance index (Ed; 0.133 1/ml-0.127 1/ml,  = 0.049) were significantly improved, but not in conventional diastolic functional indexes. Their improvements occurred in both groups; however, the degree was less prominent in patients with MVO. The degree of decrease in LGE amount and increase in LVEF was significantly correlated with improvement in LV-Ed or LA phasic function, but not with conventional diastolic functional indexes.

Conclusions: In patients with reperfused AMI, DT of early mitral inflow, phasic LA function, and LV-Ed were more sensitive diastolic functional indexes. The degree of their improvement was less prominent in patients with MVO.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100411PMC
http://dx.doi.org/10.3389/fcvm.2024.1338940DOI Listing

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