Color M-mode and pulsed wave tissue Doppler echocardiography: Powerful predictors of cardiac events after first myocardial infarction

Abstract

To assess the association between color M-mode flow propagation velocity and the early diastolic mitral annular velocity (Em) obtained with tissue Doppler echocardiography and to assess the prognostic implications of the indexes, echocardiography was performed on days 1 and 5, and 1 and 3 months after a first myocardial infarction in 67 consecutive patients. Flow propagation velocity correlated well with Em (r = 0.72, P <.0001). The ratio of peak E-wave velocity (E) to flow propagation velocity also correlated well with E/Em (r = 0.87, P <.0001). The positive predictive value of E/FPV ≥1.5 to identify patients with Killip class ≥II was 90%, and the negative predictive value 92%. The corresponding values for E/Em ≥10 were 70% and 90%. Cox proportional hazards analysis identified E/flow propagation velocity ≥1.5 (relative risk, 12.4 [95% confidence interval, 4.1-37.3]), E/Em ≥10 (relative risk, 11.5 [95% confidence interval, 3.8-34.7]), and Killip class ≥II (relative risk, 7.8 [95% confidence interval, 1.6-40.4]) to be predictors of the composite end point of cardiac death and readmission because of heart failure. Thus flow propagation velocity and Em are closely related after myocardial infarction and appear to have similar prognostic information. (J Am Soc Echocardiogr 2001;14:757-63.)