Diastolic Dysfunction After an Acute Myocardial Infarction in Patients with Antecedent Hypertension

• Published in: Journal of the American Society of Echocardiography Vol. 21; no. 2; pp. 171 - 177
• Main Authors: Andersen, Niels Holmark, PhD, Karlsen, Finn Michael, PhD, Gerdes, Jens Christian, PhD, Kaltoft, Anne, PhD, Bøttcher, Morten, PhD, Sloth, Erik, DMSc, Thuesen, Leif, DMSc, Bøtker, Hans Erik, DMSc, Poulsen, Steen Hvitfeldt, DMSc
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-02-2008
• Subjects: Adult; Aged; Angioplasty, Balloon, Coronary - methods; Blood Pressure Determination; Cardiovascular; Case-Control Studies; Coronary Angiography; Diastole; Echocardiography, Doppler, Pulsed; Female; Humans; Hypertension - complications; Hypertension - diagnosis; Male; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - diagnosis; Myocardial Infarction - therapy; Probability; Prognosis; Radionuclide Imaging - methods; Reference Values; Risk Assessment; Severity of Illness Index; Stroke Volume - physiology; Systole; Treatment Outcome; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0894-7317; 1097-6795
• DOI: 10.1016/j.echo.2007.05.026

Objective We sought to assess changes in the left ventricular systolic and diastolic function in patients with antecedent hypertension and an acute myocardial infarction. Methods A group of 38 patients with antecedent hypertension and acute myocardial infarction were compared with an age-matched nonhypertensive control group. There was a 30-day follow-up. Outcome measures were left ventricular volumes and ejection fraction, systolic velocities, and strain. Diastolic function was assessed by mitral inflow combined with tissue velocities of the mitral ring. Results Patients with antecedent hypertension did not experience any regression in the E/E’ ratio (16.5 ± 7.5 vs 17.1 ± 9.0, P = not significant) or increase in the E’/A’ ratio (0.76 ± 0.5 vs 0.84 ± 0.6, P = not significant) compared with significant improvements in E/E’ ratio (18.9 ± 8.7 vs 12.8 ± 7.4, P < .01) and E’/A’ ratio (0.76 ± 0.5 vs 1.1 ± 0.7, P < .01) in the control group. This was found despite similar changes ejection fraction, volumes, and systolic strain. Conclusions Patients with antecedent hypertension have incomplete improvement of the diastolic function compared with control subjects despite comparable left ventricular volumes and ejection fraction after an acute myocardial infarction.