Document Detail


Risk assessment in patients with depressed left ventricular function after myocardial infarction using the myocardial performance index--Survival and Ventricular Enlargement (SAVE) experience.
MedLine Citation:
PMID:  16423666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Myocardial performance index (MPI) is a noninvasive, quantitative Doppler measure of global cardiac function, integrating systolic and diastolic functions. The prognostic significance of MPI is less clear for cardiovascular (CV) events after myocardial infarction (MI) among individuals at high risk with depressed left ventricular (LV) systolic function. METHODS: We analyzed echocardiograms from 512 patients with depressed LV function after MI enrolled in the Survival and Ventricular Enlargement (SAVE) echocardiographic substudy. Baseline MPI measures were obtainable in 226 patients. The cohort was separated by median MPI (0.50). MPI was related to baseline clinical and echocardiographic characteristics, ventricular remodeling, and subsequent CV events, including recurrent MI, heart failure, CV death, and a composite of all CV end points. RESULTS: An MPI of 0.5 or more was associated with larger infarct size and reduced LV systolic function at baseline; other baseline characteristics between the groups were similar. A total of 64 (28.3%) patients experienced CV events. Baseline MPI did not influence ventricular remodeling and did not modify the relationship between ventricular dilatation and CV events. After covariate adjustment, an MPI of 0.50 or higher remained an independent predictor for adverse CV events (hazard ratio [HR], 2.00, 95% confidence interval 1.17-3.43). CONCLUSIONS: An MPI of 0.50 or greater is an independent predictor for CV events after MI in patients with known LV dysfunction.
Authors:
Nagesh S Anavekar; Atique Mirza; Hicham Skali; Ted Plappert; Martin St John Sutton; Marc A Pfeffer; Scott D Solomon;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  19     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-20     Completed Date:  2006-05-02     Revised Date:  2007-11-02    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  28-33     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. nanavekar@rics.bwh.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Comorbidity
Echocardiography, Doppler / methods
Female
Humans
Image Interpretation, Computer-Assisted / methods*
Incidence
Male
Middle Aged
Myocardial Infarction / mortality*,  ultrasonography*
Prognosis
Proportional Hazards Models
Risk Assessment / methods*
Risk Factors
Severity of Illness Index*
Survival Analysis
Survival Rate
United States / epidemiology
Ventricular Dysfunction, Left / mortality*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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