Atrioventricular plane displacement: does it predict in-hospital outcome after acute myocardial infarction?

作者：Nammas W^*; El Okda E

来源：European Review for Medical and Pharmacological Sciences, 2012, 16: 16-21.

• Atrioventricular plane displacement
• Myocardial infarction
• Outcome

Background and Objectives: Atrioventricular plane displacement is a well-accepted method for assessment of left ventricular systolic function. We explored the ability of atrioventricular plane displacement to predict in-hospital outcome in patients with acute ST-elevation myocardial infarction. %26lt;br%26gt;Materials and Methods: Ninety three patients with acute ST-elevation myocardial infarction were prospectively included. Each patient underwent trans-thoracic echocardiography for measurement of the ejection fraction by the Simpson%26apos;s method. Atrioventricular plane displacement was measured from the apical views, assessed in four different regions, namely, the septal, lateral, anterior and inferior ones, and the mean value was calculated. We used a cutoff value to classify patients into a group with atrioventricular plane displacement %26lt; 10 mm and another with atrioventricular plane displacement %26gt;= 10 mm. Similarly, patients were classified into those with ejection fraction %26lt; 40% and others with ejection fraction %26gt;= 40%. All patients were followed-up during their in-hospital stay for the occurrence of major adverse cardiac events, namely, death, heart failure, complex ventricular arrhythmias, post-infarction angina, or mechanical complications. %26lt;br%26gt;Results: During the follow-up period (3 +/- 1.5 days), major adverse cardiac events occurred in 16 (72.7%) patients with atrioventricular plane displacement %26lt; 10 mm, and in 6(8.5%) patients with atrioventricular plane displacement %26gt;= 10 mm, p %26lt; 0.01. An atrioventricular plane displacement below 10 mm was able to predict the occurrence of major events with a sensitivity 72.7%, specificity 91.5%, negative predictive value (NPV) 91.5%, positive predictive value (PVP) 72.7%. Similarly, an ejection fraction below 40% predicted the occurrence of major events with a sensitivity 72.7%, specificity 90.1%, NPV 91.4%, PVP 69.6%. We found a strong correlation between an atrioventricular plane displacement %26lt; 10 mm, and an ejection fraction %26lt; 40%, p %26lt; 0.01. %26lt;br%26gt;Conclusion: Left atrioventricular plane displacement below 10 mm, can adequately predict the occurrence of in-hospital major adverse cardiac events after acute ST-elevation myocardial infarction, with a high correlation with ejection fraction below 40%.

• 出版日期2012-3