Prognostic Value of Tissue Doppler Echocardiographic Imaging in Elderly Patients with Acute Myocardial Infarction

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 28; no. 3; pp. 298 - 302
• Main Authors: Snopek, Grażyna, Drewniak, Wojciech, Borys, Marcin, Dabrowski, Marek
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-03-2011
• Subjects: Aged; Aged, 80 and over; Echocardiography - methods; Elasticity Imaging Techniques - methods; elderly; Female; Humans; Male; myocardial infarction; Myocardial Infarction - diagnostic imaging; Prognosis; Reproducibility of Results; Sensitivity and Specificity; tissue Doppler echocardiography
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/j.1540-8175.2010.01336.x

Background: The ratio of mitral end‐diastolic velocity and mitral annular early diastolic motion velocity (E/e’) has predictive value in patients with acute coronary syndromes (ACS). Both E and e’ velocities change with age. The prognostic value of E/e’ in elderly patients with ACS has not been established yet. The aim of the study was to assess the prognostic significance of E/e’ in patients over 65 with ACS. Method: The study involved 168 patients, mean age 79 years. Echocardiography was performed within first 24 hours of ACS. Clinical evaluation, 6‐minute walk test, echocardiography and plasma level of NT pro‐BNP were performed 12 months later. Results: Patients, who were still alive after 1‐year follow‐up had significantly lower E/e’ during hospitalization: 11.1 ± 3 versus 15.1 ± 5 (P < 0.05). The optimal cutoff value of E/e’ differentiating survivors and nonsurvivors after 12 month follow‐up was 12. Initial E/e’ was an independent predictor of mortality during 1‐year follow‐up. E/e’ ratio during hospitalization significantly correlated with NT pro‐BNP concentration (r = 0.48, P < 0.001) and 6‐minute walking distance: (r =–0.32, P < 0.05) after 1‐year follow‐up. Conclusions: (1) In patients over 65 with myocardial infarction, E/e’ above 12 is an independent predictor of death during 1‐year follow‐up. (2) E/e’ ratio in acute phase of myocardial infarction correlated significantly with N pro‐BNP level and 6‐minute walking distance after 1‐year follow‐up. (Echocardiography 2011;28:298‐302)