Myocardial performance index as an echocardiographic predictor of early in-hospital heart failure during first acute anterior ST-elevation myocardial infarction.

Abstract

ObjectivesTo determine the value of Myocardial Performance Index (MPI) as an echocardiographic predictor of early in-hospital heart failure (HF) during first acute anterior ST-Elevation Myocardial Infarction (STEMI).BackgroundMyocardial infarction induces variable degrees of impairment in left ventricular (LV) systolic and diastolic functions. The ejection fraction (EF) and transmitral flow, the most frequently used methods for evaluation of systolic and diastolic functions respectively, both have considerable limitations. The MPI is a single parameter, capable of estimating combined systolic and diastolic performance and lacks such limitations.MethodsWe enrolled 60 patients presented with a first acute anterior STEMI who have undergone primary PCI. 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”. Besides, clinical and echocardiographic variables were analyzed and CHF was defined as Killip class ≥ II.ResultsEarly in-hospital HF occurred in 23 of patients (38%). Ejection fraction was found to have a highly significant negative correlation with the development of in-hospital HF (p = .0001), while MPI was found to have a highly significant positive correlation (p = .0001). A cut-off point of MPI > 0.73 showed a very high specificity (94.6%) and sensitivity (78.3%) for identifying patients with HF. On the other hand, a cut-off point of EF ≤ 33% has shown 94.6% specificity and 56.5% sensitivity for HF prediction.ConclusionsThe MPI might be a strong predictor of in-hospital HF after first acute anterior STEMI.