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Archives des maladies du coeur et des vaisseaux 1988-Nov

[Prognostic value at 12 months of two-dimensional echocardiography performed during the acute phase of myocardial infarction. A prospective study of 140 patients].

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D Carrie
M Fauvel
M Y Douste-Blazy
B Mordant
P Bernadet

Keywords

Abstract

A two-dimensional echocardiography was performed in the acute phase of myocardial infarction in 140 consecutive patients admitted to hospital for transmural infarction 12 +/- 3 days on average after necrosis was formed. The examination consisted of 4 ventricular sections, including 2 through the apex: 8 ventricular segments were individualized, to be interpreted only when 50 p. 100 of the endocardium was visualized. An echocardiographic score was devised for the kinetics of each ventricular segment, i.e.: -1:dyskinetic, 0:akinetic, +1:hypokinetic, +2: normal, +3:hyperkinetic. The maximum score corresponding to normal contraction of all segments was 16. The hospital results were a mean score of 6.52 +/- 2.90 for 73 anterior and/or lateral infarctions and a mean score of 12.5 +/- 2.38 for 67 inferior infarctions (p less than 0.001). Correlations between echographic scores and angiographic ejection fractions were studied in 99 of the 140 patients. Good correlation between the two examinations was found in 91 cases, with a less than or equal to 6/16 score corresponding to a less than or equal to 40 p. 100 ejection fraction, and a greater than or equal to 7/16 score to a less than or equal to 40 p. 100 ejection fraction. This showed that echocardiography can be relied upon to detect abnormalities of left ventricular kinetics in myocardial infarction. 137 patients were followed up for a mean period of 16.4 months (range: 12 to 25 months). The follow-up was clinical and included angina, recurrent or extended infarction, heart failure, aorto-coronary bypass and mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

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