Prognostic implications of regional hyperkinesia and remote asynergy of noninfarcted myocardium
Abstract
To determine the clinical significance of regional hyperkinesia and remote asynergy of noninfarcted areas in patients with a first acute myocardial infarction (AMI), 2-dimensional echocardiography was performed in 113 consecutive patients within 12 hours after admission to the coronary care unit. In 98 patients (87%) all segments of the left ventricular wall were recorded. Infarct-associated asynergy was anterior in 63 and inferior in 35 patients. Regional hyperkinesia was present in 66 patients (67%)--44 of 63 with anterior (69%) and 22 of 35 with inferior (63%) infarcts--and was more frequently seen in patients with 1- and 2-vessel coronary artery disease (CAD) than in patients with 3-vessel CAD (87 and 72% vs 25%, p less than 0.001). In contrast to enzymatic infarct size, absence of regional hyperkinesia was significantly associated with a higher left ventricular wall motion score (p less than 0.01). Twenty patients died within 30 days after onset of AMI; in 15 (75%) regional hyperkinesia was absent. Absence of regional hyperkinesia, especially in anterior infarcts, was associated with a high mortality rate (13 of 19 patients [68%]). Remote asynergy, i.e., not adjacent to the infarct area and supposed to be related to anothe...Continue Reading
References
Citations
Reduced coronary vasodilator function in infarcted and normal myocardium after myocardial infarction
Left ventricular wall motion with and without Q-wave disappearance after acute myocardial infarction
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