Prognostic significance of left venticular mass index in hypertensive patients with acute myocardial infarction

Introduction: Left ventricular mass index (LVMi) was signifi cantly associated with cardiovascular mortality. Patients with an acute myocardial infarction (AMI) and hypertension antecedent to the acute coronary event present an elevated left ventricular end-diastolic pressure (LVEP), which is a prognostic indicator. The aim of the study was to fi nd the correlation between left ventricular hypertrophy (LVH) and echocardiographic parameters of increased LVEP in hypertensive patients with AMI. Methods: 98 hypertensive patients admitted with AMI with ST-segment elevation were evaluated during the first week by: clinical examination, 12 lead standard ECG, echocardiographic measurements of: LVMi; cut off values for LVH were LVMi > 115g/m2 in males and > 95g/m2 in females, left atrial volume index (LAVi); pulsed Doppler echocardiography for mitral inflow, tricuspid inflow, pulmonary venous flow evaluation, pulsed tissue Doppler echocardiography at lateral and medial corner of mitral annulus, color Mmode echocardiography. E/e’ratio, E/vp ratio and ar-A duration were calculated. Pulmonary artery systolic pressure (PASP) was determinated by applying modified Bernoulli’s equation. LVEF measured by Simpson method was <45% in all patients. Results: Using chi squared (CS), odd ratio (OR) and relative risk (RR), we found statistically significant correlations between: 1. LVH and LAVi >32 ml/m2 (CS: 12.65518, OR: 4.949495, RR: 1.724074) 2. LVH and E/e’ratio >13 (CS: 4.874022, RR: 3.528409, RR: 1.374579) 3. LVH and E/vp >1,5 (CS: 0.380435, OR: 19.99552, RR: 0.109375) and correlations, but without statistical significance, between: 1. LVH and aR-A >30 ms (CS: 3.406644, OR: 2.461538, RR:1.292308) 2. LVH and PASP >35 mm Hg (CS: 0.439169, OR: 1.6875, RR: 1.211538). Conclusions: 1. Hypertensive patients with increased LVMi in acute phase of myocardial infarction had elevated LVEP. This was revealed by correlation with echocardiographic parameters used for fi lling pressure evaluation. 2. Stastistically significant correlations were obtained between LVMi and LAVi, E/e’ratio and E/vp.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)