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Diastolic Function in Acute Myocardial Infarction:A Radionuclide Study

Institute of lnternal Medicine, Cardiology, Cardiovascular Surgery and Institute of Nuclear Medicine, 2nd School of Medicine, Naples, Italy

Correspondence: For reprints contact: Domenico Bonaduce, MD, via Aniello Falcone 394, 80127 Naples, Italy.

ABSTRACT

We studied left ventricular diastolic function by equilibrium gated radionuclide angiography in patients as follows: 75 with acute myocardial infarction (AMI), 35 with anterior or anteroseptal necrosis (Group A) and 40 with inferior, inferolateral, or posterior necrosis(Group I). The ejection fraction (EF) was lower in Group A than Group I (41.9 ±2.5 vs. 57.1 ±2.0%, p < 0.001), as was peak diastolic filling rate normalized to end diastolic volume(PDFR-EDV/sec) (1.9 ±0.1 vs.2.4 ±0.1 EDV/sec,p < 0.05).PDFR normalized to stroke volume was similar in both groups. An excellent linear correlation was found between EF and PDFR-EDV/sec in the total study population. Isovolumic relaxation period (IRP) was beyond our upper normal value of 94 msec in 64% of patients and it was shorter in Group A than I (95.8 ±12.7 vs. 147.0 ±13.6 msec, p < 0.05). The presence of shorter IRP in Group A than in I is probably a result of an earlier mitral valve opening as a consequence of higher left atrial pressure