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28 June 2012

Early echocardiographic predictors of increased left ventricular end-diastolic pressure three months after myocardial infarction in rats

Paula S. AzevedoABCDEF, Bertha F. PolegatoBCDE, Marcos F. MinicucciABCDEF, Stephan M. PioBCDE, Igor A. SilvaBCDE, Priscila P. SantosBCDE, Katashi OkoshiBCDE, Sergio A.R. PaivaABCDEF, Leonardo A.M. ZornoffABCDEF

DOI: 10.12659/MSM.883202

Med Sci Monit 2012; 18(7): BR253-258

Abstract

Background: The objective of this study was to determine the early echocardiographic predictors of elevated left ventricular end-diastolic pressure (LVEDP) after a long follow-up period in the infarcted rat model.
Material/Methods: Five days and three months after surgery, sham and infarcted animals were subjected to transthoracic echocardiography. Regression analysis and receiver-operating characteristic (ROC) curve were performed for predicting increased LVEDP 3 months after MI.
Results: Among all of the variables, assessed 5 days after myocardial infarction, infarct size (OR: 0.760; CI 95% 0.563–0.900; p=0.005), end-systolic area (ESA) (OR: 0.761; CI 95% 0.564–0.900; p=0.008), fractional area change (FAC) (OR: 0.771; CI 95% 0.574–0.907; p=0.003), and posterior wall-shortening velocity (PWSV) (OR: 0.703; CI 95% 0.502–0.860; p=0.048) were predictors of increased LVEDP. The LVEDP was 3.6±1.8 mmHg in the control group and 9.4±7.8 mmHg among the infarcted animals (p=0.007). Considering the critical value of predictor variables in inducing cardiac dysfunction, the cut-off value was 35% for infarct size, 0.33 cm2 for ESA, 40% for FAC, and 26 mm/s for PWSV.
Conclusions: Infarct size, FAC, ESA, and PWSV, assessed five days after myocardial infarction, can be used to estimate an increased LVEDP three months following the coronary occlusion.

Keywords: Time Factors, ROC Curve, Myocardial Infarction - ultrasonography, Diastole - physiology, Ventricular Pressure - physiology

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Medical Science Monitor eISSN: 1643-3750