121: Left ventricular diastolic function evaluation by left atrial volume and myocardial performance index in patients with acute myocardial infarction

Abstract

Both left atrial volume index (LAVI) and myocardial performance index (MPI) were proved to be reliable parameters of left ventricular (LV) diastolic function. We aimed to assess their usefulness in the setting of acute myocardial infarction (AMI) in comparison with conventional diastolic parameters A cohort of three hundred and sixty patients with AMI (72% with ST segment elevation) with a mean age of 61.6 ±12.4 years (79% males; 39% diabetics) was enrolled. Patients with atrial fibrillation or conduction abnormalities were excluded from the study. All patients had a conventional and Doppler echocardiography assessment 24 to 36 hours after admission coupled with a measurement of LAVI and MPI index by conventional Doppler method (MPI1), tissue Doppler method at the lateral side of the mitral annulus (MPI2) and at its medial side (MPI3). Correlation between parameters was evaluated by Pearson coefficient (r). The three MPI indexes were significantly correlated to these parameters of LV diastolic function: The early diastolic tissue velocities at the lateral side of the mitral annulus (Ea l) (r1=−0.31, r2=−0.36, r3=−0.46, p<0.001) and its medial side (Ea s) (r1=−0.37, r2=−0.35, r3=−0.34, p<0.001) and the combined parameter Early diastolic velocity by conventional Doppler (E)/ Ea s (r1=0.2, r2=0.2, p<0.01). LVAI was not correlated to MPI (r1=0.14, r2=0.11, r3=0.11, p>0.05) and it was only correlated with the early diastolic tissue velocity at the medial side of the mitral annulus (Ea s) (r=−0.18, p<0.05). While myocardial performance conventional and tissue indexes are strongly correlated with diastolic LV function in the acute phase of myocardial infarction, left atrial volume index seems be not sensitive to acute but only chronic alterations of this function.