MYOCARDIAL PERFORMANCE INDEX AS AN ECHOCARDIOGRAPHIC PREDICTOR OF EARLY HEART FAILURE IN ACUTE ST ELEVATION MYOCARDIAL INFARCTION

Abstract

Myocardial infarction causes variable degrees of left ventricular (LV) systolic and diastolic dysfunctions. The ejection fraction (EF) and transmitral ow are the frequently used method for evaluating the systolic and diastolic functions respectively with considerable limitations. The MPI is a single independent parameter, capable of estimating both systolic and diastolic performance combined and lacks such limitations. We enrolled 100 patients presented with a rst acute STEMI who have undergone Thrombolysis. Echocardiography was done within 24 h of chest pain with measurement of MPI. The LV MPI was calculated as (isovolumic contraction time ''ICT” + relaxation time ''IRT”)/Ejection time ''ET”. simultaneously, clinical and echocardiographic variables were analyzed and CHF was dened as Killip class >=II. Results: Early in-hospital HF occurred in 38 of patients (38%). Ejection fraction was found to have a highly signicant negative correlation with the development of in-hospital HF (p = .0001), while MPI was found to have a highly signicant positive correlation (p = .0001). Acut-off point of MPI > 0.72 showed a very high specicity (93.6%) and sensitivity (77.3%) for identifying patients with HF. On the other hand, a cut-off point of EF <=32% has shown 93.4% specicity and 57.5% sensitivity for HF prediction. Conclusions: The MPI might be a strong predictor of in-hospital HF after acute ST elevation M