Title:
Correlation of Left Ventricular Diastolic Function with the Clinical Course and Outcome of Acute Myocardial Infarction: A Brief Review

Authors:
Beka Mikeladze, Nino Zhvania, Giorgi Nikolaishvili & Naira Kobaladze, Georgia

Abstract:

Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality globally, posing significant challenges in cardiology and internal medicine. AMI is characterized by the sudden interruption of blood flow to a portion of the myocardium, resulting in ischemic injury and myocardial necrosis. This condition presents a wide range of clinical manifestations, from asymptomatic cases to severe complications. Advances in treatment underscore the need for a comprehensive understanding of AMI's path physiology and prognostic indicators to improve patient outcomes. One crucial aspect of myocardial function impacted by AMI is left ventricular diastolic function (LVDF), which involves the heart's ability to relax and fill with blood during diastole. Impaired LVDF can be an early sign of myocardial injury and is a significant determinant of clinical outcomes post-AMI. Ischemic damage to the myocardium can lead to changes in LVDF, affecting relaxation, ventricular filling, and myocardial stiffness, thereby influencing the overall prognosis. Research links LV diastolic dysfunction (LVDD) with various adverse clinical outcomes in AMI patients, including exacerbated heart failure symptoms, adverse ventricular remodeling, and increased risk of chronic heart failure and cardiovascular mortality. Echocardiography, particularly Doppler imaging, is vital for assessing LVDF, with the E/A and E/e' ratios serving as key parameters. An abnormal E/A ratio suggests impaired LV relaxation or increased stiffness, while an elevated E/e' ratio indicates increased LV filling pressures (LVFP) and is associated with worse outcomes. Studies have shown that elevated E/e' ratios predict higher left atrial pressures and increased heart failure risk, correlating with prolonged hospitalization and higher mortality in AMI patients. Conversely, normalization of diastolic parameters can indicate a positive response to therapy and improved recovery. In conclusion, assessing LVDF through echocardiographic parameters like the E/A and E/e' ratios is essential in managing AMI patients. These measures provide valuable insights into LVFP and LVDF, crucial for understanding AMI's clinical course and optimizing patient care. Ongoing research and clinical application of these parameters are vital for enhancing prognostic accuracy and treatment strategies for AMI.

DOI: http://dx.doi.org/10.51505/ijmshr.2024.8405