Prognostic value of left ventricular diastolic function and association with heart rate variability after a first acute myocardial infarction

• Published in: British heart journal 2001-10, Vol.86 (4), p.376-380
• Main Authors: Poulsen, S H, Jensen, S E, Møller, J E, Egstrup, K
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angina pectoris; Angioplasty; Arrhythmias, Cardiac - diagnostic imaging; Arrhythmias, Cardiac - physiopathology; autonomic balance; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular Medicine; Congestive heart failure; Coronary heart disease; Correlation analysis; Death, Sudden, Cardiac - etiology; diastole; Diastole - physiology; Echocardiography, Doppler - methods; Electrocardiography, Ambulatory; Female; Health aspects; Heart; Heart attack; Heart attacks; Heart beat; Heart failure; Heart rate; Heart ventricle, Left; Humans; infarction; Kinases; Male; Measurement; Medical sciences; Middle Aged; Mortality; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Prognosis; Prospective Studies; Risk factors; Studies; Survival Analysis; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - physiology
• ISSN: 1355-6037; 0007-0769; 1468-201X
• DOI: 10.1136/heart.86.4.376

OBJECTIVE To study the prognostic value of left ventricular (LV) diastolic function and its relation with autonomic balance expressed by heart rate variability (HRV) in patients after a first acute myocardial infarction. DESIGN The study population consisted of 64 consecutive patients with first acute myocardial infarction and 31 control subjects. Long and short term HRV indices were evaluated by 24 hour Holter monitoring, and LV systolic and diastolic function were assessed by two dimensional and Doppler echocardiography before discharge. Patients were divided into two groups: those with restrictive LV filling characteristics (deceleration time ⩽ 140 ms) and those with non-restrictive LV filling characteristics (deceleration time > 140 ms). RESULTS Both long and short term HRV indices were significantly reduced in patients with restrictive LV filling compared with the non-restrictive group and control subjects. Mitral deceleration time and isovolumetric relaxation time correlated weakly but significantly with all indices of HRV whereas ejection fraction correlated weakly with the long term HRV indices. The mean follow up time was 14.9 (8.7) months. Multivariate analysis showed that mitral deceleration time (χ2 = 6.4, p