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Stress Tissue Doppler
Echocardiography as a Prognostic Implication after Acute Myocardial
Infarction
Samia Sharf Eldin
Cardiology Department, Faculty of Medicine, Tanta University, Egypt
Tanta Med. Sc. J 2008; 3(4):40-46
Article type: Original article
Background/Aim: Tie index could be a predictor of
both systolic and diastolic myocardial performance after acute
myocardial infarction (AMI). Low-dose dobutamine stress
echocardiography identifies viability in patients with myocardial
dysfunction, and predicts the reversibility of myocardial function
after AMI. Pulsed wave -Doppler tissue imaging (DTI) allows
measuring regional myocardial velocities, and changes of both
systolic and diastolic myocardial function. This study aimed to
assess the prognostic implication of resting and stress tissue
Doppler echocardiographic variables in patients with first acute
uncomplicated anterior myocardial infarction. Patients &Methods:
This study included 159 patients, they were divided into two groups;
patients group included 129 patients with first acute anterior MI
treated with thrombolytic therapy and control group included 30 age-
and sex- matched healthy subjects. All patients were subjected to
baseline demographic characteristics include age, sex, obesity and
clinical data analysis; also coronary risk factors were assessed.
Complete resting echocardiographic evaluation and resting Doppler
tissue imaging (DTI) study for measuring Tei index and low dose
dobutamine stress echocardiography to assess myocardial viability
were done in all patients. Pulsed-wave Doppler tissue imaging study
before and during low dose dobutamine stress echocardiography and
follow-up of major adverse cardiac events by resting conventional
echocardiography at one month was done for every patient. Results:
Patients were sub-divided into two groups according to the
myocardial functional improvement at follow up; group I: included 68
patients with no improvement of myocardial function, and group II:
included 52 patients with improvement on follow up. There was
significant correlation between group I and the resting
echocardiographic data, and there was significant positive
correlation between group II and the viability demonstrated with low
dose dobutamine echocardiography (LDDE), DTI, or both techniques
together. During follow-up, two patients died from non cardiac
cause, the remaining patients had cardiac events, forming the event
group (group A), and the non-event group (group B). Patients in
group A were significantly older than patients in group B (P<0.000).
However, there was significant positive correlation between non
event group and the myocardial viability. Tei index was the most
significant constant independent predictor of early cardiac events.
Conclusion: Resting and stress tissue Doppler echocardiographic
variables found to have a significant prognostic implication in
patients with acute anterior myocardial infarction
ICID 881848
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