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. 2001 May;85(5):527–532. doi: 10.1136/heart.85.5.527

Short early filling deceleration time on day 1 after acute myocardial infarction is associated with short and long term left ventricular remodelling

P Otasevic, A Neskovic, Z Popovic, A Vlahovic, D Bojic, M Bojic, A Popovic
PMCID: PMC1729741  PMID: 11303004

Abstract

OBJECTIVE—To assess the relations between early filling deceleration time, left ventricular remodelling, and cardiac mortality in an unselected group of postinfarction patients.
DESIGN AND PATIENTS—Prospective evaluation of 131 consecutive patients with first acute myocardial infarction. Echocardiography was performed on day 1, day 2, day 3, day 7, at three and six weeks, and at three, six, and 12 months after infarction. According to deceleration time on day 1, patients were divided into groups with short (< 150 ms) and normal deceleration time (⩾ 150 ms).
SETTING—Tertiary care centre.
RESULTS—Patients with a short deceleration time had higher end systolic and end diastolic volume indices and a higher wall motion score index, but a lower ejection fraction, in the year after infarction. These patients also showed a significant increase in end diastolic (p < 0.001) and end systolic volume indices (p = 0.007) during the follow up period, while ejection fraction and wall motion score index remained unchanged. In the group with normal deceleration time, end diastolic volume index increased (p < 0.001) but end systolic volume index did not change; in addition, the ejection fraction increased (p = 0.002) and the wall motion score index decreased (p < 0.001). One year and five year survival analysis showed greater cardiac mortality in patients with a short deceleration time (p = 0.04 and p = 0.02, respectively). In a Cox model, which included initial ejection fraction, infarct location, and infarct size, deceleration time on day 1 was the only significant predictor of five year mortality.
CONCLUSIONS—A short deceleration time on day 1 after acute myocardial infarction can identify patients who are likely to undergo left ventricular remodelling in the following year. These patients have a higher one year and five year cardiac mortality.


Keywords: deceleration time; left ventricular remodelling; acute myocardial infarction

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Figure 1  .

Figure 1  

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Receiver operating characteristic curve analysis to establish the most accurate value of deceleration time predictive of cardiac death.

Figure 2  .

Figure 2  

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Changes in ejection fraction (A), wall motion score index (B), and end diastolic (C) and end systolic volume index (D) during the follow up in patients with and without short deceleration time on day 1. EDVi, end diastolic volume index; ESVi, end systolic volume index; WMSi, wall motion score index. *p < 0.05; †p < 0.01; ‡p < 0.001, between groups.

Figure 3  .

Figure 3  

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Actuarial survival curve in patients with and without short deceleration time on day 1 (p = 0.02).

graphic file with name hrt-csoonm.f1.jpg

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