Impacts of Diastolic Function on Clinical Outcomes in Young Patients with Acute Myocardial Infarction

Eun Young Cho, Myung Ho Jeong, Hyun Ju Yoon, Yong Cheol Kim, Seok-Joon Sohn, Min Chul Kim, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Jae Young Cho, Kye Hun Kim (+1 others)
2018 Korean Journal of Medicine  
Background/Aims: The impact of left ventricular (LV) diastolic function and filling pressure on clinical outcomes in young patients with acute myocardial infarction (AMI) has been poorly studied. Therefore, the aim of this study was to investigate the impact of LV diastolic function and LV filling pressure on major adverse cardiac events (MACEs) in young patients with AMI. Methods: A total of 200 young patients (males < 45 year, females < 55 year) with AMI were divided into two groups according
more » ... wo groups according to the diastolic function; normal (n = 46, 39.5 ± 5.3 years) versus abnormal (n = 154, 43.5 ± 5.1 years). Results: Despite regional wall motion abnormalities, normal LV diastolic function was not uncommon in young AMI patients (23.0%). During the 40 months of clinical follow-up, MACEs developed in 26 patients (13.0%); 14 re-percutaneous coronary intervention (7.0%), 8 recurrent MI (4.0%), and 4 deaths (2.0%). MACEs did not differ between the normal and abnormal diastolic function group (13.6% vs. 10.9%, p = 0.810), but MACEs were significantly higher in the high LV filling pressure group than the normal LV filling pressure group (36.8% vs. 10.5%, p < 0.001). On multivariate analysis, high LV filling pressure was an independent predictor of MACEs (hazard ratio 3.022, 95% confidence interval 1.200-7.612, p = 0.019). Conclusions: This study suggested that measurement of the LV filling pressure (E/e' ratio) would be useful in the risk stratification of young patients with AMI. However, it would be necessary to monitor this category of patient more carefully. (Korean J Med 2018;93:538-547)
doi:10.3904/kjm.2018.93.6.538 fatcat:qjrnmh6zz5dzlmadrftqowle2q