Pseudonormal and restrictive filling patterns predict left ventricular dilation and cardiac death after a first myocardial infarction: a serial color M-mode doppler echocardiographic study
Jacob E. Møller, MDa,
Eva Søndergaard, MDa,
Steen H. Poulsen, MD, PhDb and
Kenneth Egstrup, MD, DmSci, FESCa
a Department of Medicine, Svendborg Hospital, Svendborg,Denmark
b Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
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Figure 1 Pulsed Doppler recordings of transmitral filling (top) and color M-mode Doppler echocardiography (bottom). A, Normal filling pattern (DT 165 ms, Vp 63 cm/s). B, Impaired relaxation (DT 296 ms, Vp 39 cm/s). C, Pseudonormal filling pattern (DT 205 ms, Vp 33 cm/s). D, Restrictive filling (DT 110 ms, Vp 43 cm/s).
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Figure 2 Serial changes in end-systolic volume index (top) and end-diastolic volume index (bottom) in 100 three-month survivors after MI. Data are presented as the mean value ± SEM. *p < 0.001, compared with baseline (paired sample t test). Triangles = normal filling; squares = impaired relaxation; diamonds = pseudonormal filling; circles = restrictive filling. See text for definitions of groups.
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Figure 3 The effect of LV filling patterns on survival. Mortality was significantly higher in patients with impaired relaxation (p = 0.02), pseudonormal filling (p < 0.00005) or restrictive filling (p < 0.00005) than in patients with a normal filling pattern. Short-hatch/dotted line (top) = normal filling pattern; dotted line = impaired relaxation; long-hatch line = pseudonormal filling; solid line (bottom) = restrictive filling.
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