Limited efficacy of myocardial tissue doppler for predicting left ventricular filling pressure, severe pulmonary edema, and respiratory failure in acute myocardial infarction

Wen Hwa Wang, Shih Hung Hsiao, Kuan Rau Chiou, Chun Peng Liu, Wei Chun Huang, Shih Kai Lin, Feng You Kuo, Chin Chang Cheng, Ko Long Lin

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Regional parameters such as E/e (ratio of early-diastolic mitral inflow elocity to early-diastolic mitral annular elocity)may not accurately reflect global left ventricular (L) diastolic function in acutemyocardial infarction (AMI), and the use of these parameters for predicting severe pulmonary edema and respiratory failure during acute phase of AMI is questionable. Methods and Results: Four hundred patients with first AMI were catheterized for possible coronary interention and measurement of L filling pressure (LFP). Although E/regional e correlated linearly with LFP, it was not a sufficient correlation to identify an eleated LFP in AMI. For purposes of assessing LFP, aerage e was no better than regional e. Regarding culprit lesions, the correlation between E/regional e and LFPwas weaker in the single left anterior descending artery (LAD)-culprit AMI than in any other culprit or in multiple-essel disease. Comparisons of L ejection fraction (LEF) reealed weak correlations between LFP and E/regional e in patients with LEF of 45-55%. Seere pulmonary edema and respiratory failure were significantly associated with LEF (for pulmonary edema, OR 0.944, 95% CI 0.908-0.982, p = 0.004; for respiratory failure, OR 0.95, 95% CI 0.910-0.993, p = 0.022) and LFP (for pulmonary edema, OR 1.13, 95% CI 1.074-1.190, p < 0.0001; for respiratory failure, OR 1.077, 95% CI 1.021-1.135, p = 0.006). Although LFP was an independent predictor of severe pulmonary edema and respiratory failure, E/e was a poor substitute for LFP in terms of predictie power (all p > 0.05). Conclusion: E/e has an imperfect efficacy for predicting LFP, severe pulmonary edema and respiratory failure in the acute phase of AMI. (Trial registry: ClinicalTrials.go; No.: NCT01168609; URL: clinicaltrials.go).

Original languageEnglish
Pages (from-to)206-215
Number of pages10
JournalActa Cardiologica Sinica
Volume28
Issue number3
Publication statusPublished - Sep 1 2012
Externally publishedYes

Fingerprint

Ventricular Pressure
Pulmonary Edema
Respiratory Insufficiency
Infarction
Myocardial Infarction
Pressure
Registries
Arteries

Keywords

  • E/e-
  • Left ventricular filling pressure
  • Myocardial infarction
  • Pulmonary edema
  • Respiratory failure
  • Tissue Doppler

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Limited efficacy of myocardial tissue doppler for predicting left ventricular filling pressure, severe pulmonary edema, and respiratory failure in acute myocardial infarction. / Wang, Wen Hwa; Hsiao, Shih Hung; Chiou, Kuan Rau; Liu, Chun Peng; Huang, Wei Chun; Lin, Shih Kai; Kuo, Feng You; Cheng, Chin Chang; Lin, Ko Long.

In: Acta Cardiologica Sinica, Vol. 28, No. 3, 01.09.2012, p. 206-215.

Research output: Contribution to journalArticle

Wang, Wen Hwa ; Hsiao, Shih Hung ; Chiou, Kuan Rau ; Liu, Chun Peng ; Huang, Wei Chun ; Lin, Shih Kai ; Kuo, Feng You ; Cheng, Chin Chang ; Lin, Ko Long. / Limited efficacy of myocardial tissue doppler for predicting left ventricular filling pressure, severe pulmonary edema, and respiratory failure in acute myocardial infarction. In: Acta Cardiologica Sinica. 2012 ; Vol. 28, No. 3. pp. 206-215.
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T1 - Limited efficacy of myocardial tissue doppler for predicting left ventricular filling pressure, severe pulmonary edema, and respiratory failure in acute myocardial infarction

AU - Wang, Wen Hwa

AU - Hsiao, Shih Hung

AU - Chiou, Kuan Rau

AU - Liu, Chun Peng

AU - Huang, Wei Chun

AU - Lin, Shih Kai

AU - Kuo, Feng You

AU - Cheng, Chin Chang

AU - Lin, Ko Long

PY - 2012/9/1

Y1 - 2012/9/1

N2 - Background: Regional parameters such as E/e (ratio of early-diastolic mitral inflow elocity to early-diastolic mitral annular elocity)may not accurately reflect global left ventricular (L) diastolic function in acutemyocardial infarction (AMI), and the use of these parameters for predicting severe pulmonary edema and respiratory failure during acute phase of AMI is questionable. Methods and Results: Four hundred patients with first AMI were catheterized for possible coronary interention and measurement of L filling pressure (LFP). Although E/regional e correlated linearly with LFP, it was not a sufficient correlation to identify an eleated LFP in AMI. For purposes of assessing LFP, aerage e was no better than regional e. Regarding culprit lesions, the correlation between E/regional e and LFPwas weaker in the single left anterior descending artery (LAD)-culprit AMI than in any other culprit or in multiple-essel disease. Comparisons of L ejection fraction (LEF) reealed weak correlations between LFP and E/regional e in patients with LEF of 45-55%. Seere pulmonary edema and respiratory failure were significantly associated with LEF (for pulmonary edema, OR 0.944, 95% CI 0.908-0.982, p = 0.004; for respiratory failure, OR 0.95, 95% CI 0.910-0.993, p = 0.022) and LFP (for pulmonary edema, OR 1.13, 95% CI 1.074-1.190, p < 0.0001; for respiratory failure, OR 1.077, 95% CI 1.021-1.135, p = 0.006). Although LFP was an independent predictor of severe pulmonary edema and respiratory failure, E/e was a poor substitute for LFP in terms of predictie power (all p > 0.05). Conclusion: E/e has an imperfect efficacy for predicting LFP, severe pulmonary edema and respiratory failure in the acute phase of AMI. (Trial registry: ClinicalTrials.go; No.: NCT01168609; URL: clinicaltrials.go).

AB - Background: Regional parameters such as E/e (ratio of early-diastolic mitral inflow elocity to early-diastolic mitral annular elocity)may not accurately reflect global left ventricular (L) diastolic function in acutemyocardial infarction (AMI), and the use of these parameters for predicting severe pulmonary edema and respiratory failure during acute phase of AMI is questionable. Methods and Results: Four hundred patients with first AMI were catheterized for possible coronary interention and measurement of L filling pressure (LFP). Although E/regional e correlated linearly with LFP, it was not a sufficient correlation to identify an eleated LFP in AMI. For purposes of assessing LFP, aerage e was no better than regional e. Regarding culprit lesions, the correlation between E/regional e and LFPwas weaker in the single left anterior descending artery (LAD)-culprit AMI than in any other culprit or in multiple-essel disease. Comparisons of L ejection fraction (LEF) reealed weak correlations between LFP and E/regional e in patients with LEF of 45-55%. Seere pulmonary edema and respiratory failure were significantly associated with LEF (for pulmonary edema, OR 0.944, 95% CI 0.908-0.982, p = 0.004; for respiratory failure, OR 0.95, 95% CI 0.910-0.993, p = 0.022) and LFP (for pulmonary edema, OR 1.13, 95% CI 1.074-1.190, p < 0.0001; for respiratory failure, OR 1.077, 95% CI 1.021-1.135, p = 0.006). Although LFP was an independent predictor of severe pulmonary edema and respiratory failure, E/e was a poor substitute for LFP in terms of predictie power (all p > 0.05). Conclusion: E/e has an imperfect efficacy for predicting LFP, severe pulmonary edema and respiratory failure in the acute phase of AMI. (Trial registry: ClinicalTrials.go; No.: NCT01168609; URL: clinicaltrials.go).

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KW - Pulmonary edema

KW - Respiratory failure

KW - Tissue Doppler

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