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한국심초음파학회 Journal of Cardiovascular Imaging Journal of Cardiovascular Imaging 제24권 제3호
발행연도
2016.1
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208 - 214 (7page)

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Background: Incidence of diastolic dyssynchrony (DD) and its impact on functional recovery of left ventricle (LV) after ST segment elevation myocardial infarction (STEMI) is not known. Methods: Consecutive patients with STEMI who underwent successful revascularization were prospectively enrolled. Echocardiography with tissue Doppler imaging was performed within 48 hours of admission and at 6 months. LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), ejection fraction (EF), and left atrial volume index (LAVI) were calculated. Diastolic delay was calculated from onset of QRS complex to peak of E wave in tissue Doppler image and presented as maximal temporal difference between peak early diastolic velocity of 6 basal segments of LV (TeDiff). Study patients were compared with demographically matched control group. Results: Forty eight consecutive patients (55 ± 10 years, 88% male) and 24 controls (56 ± 6 years, 88% male) were included. TeDiff was higher in STEMI than in controls (35.9 ± 19.9 ms vs. 26.3 ± 6.8 ms, p = 0.025). Presence of DD was higher in STEMI than controls (58% vs. 33%, p = 0.046) according to calculated cut-off value (≥ 29 ms). There was no correlation between TeDiff and change in EDVI, ESVI, and LAVI at 6 months, however TeDiff and change in EF at 6 months was positively correlated (r = 0.328, p = 0.023). Patients with baseline DD experienced remodeling less frequently compared to patients without baseline DD (11% vs. 38%, p = 0.040) during follow-up. Conclusion: STEMI disrupts diastolic synchronicity of LV. However, DD during acute phase of STEMI is associated with better recovery of LV thereafter. This suggests that DD is associated with peri-infarct stunned myocardium that is salvaged with primary intervention as well as infarct size.
#Diastolic dyssynchrony · Myocardial infarction · Remodeling.

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참고문헌 (21)

참고문헌 신청
Prasad SB / 2012 / Serial Doppler echocardiographic assessment of diastolic dysfunction during acute myocardial infarction / Echocardiography 29:1164~1171 google schola Bonow RO / 1981 / Impaired left ventricular diastolic filling in patients with coronary artery disease: assessment with radionuclide angiography / Circulation 64:315~323 google schola Temporelli PL / 2004 / Doppler-derived mitral deceleration time as a strong prognostic marker of left ventricular remodeling and survival after acute myocardial infarction:results of the GISSI-3 echo substudy / J Am Coll Cardiol 43:1646~1653 google schola Ueno Y / 2002 / An early predictor of left ventricular remodeling after reperfused anterior acute myocardial infarction: ratio of peak E wave velocity/flow propagation velocity and mitral E wave deceleration time / Echocardiography 19(7Pt 1):555~563 google schola Nucifora G / 2010 / Impact of left ventricular dyssynchrony early on left ventricular function after first acute myocardial infarction / Am J Cardiol 105:306~311 google schola

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