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Time course of cardiac structural, functional and electrical changes in asymptomatic patients after myocardial infarction: their inter-relation and prognostic impact

Peter Gaudron, MD^a, Ingrid Kugler, MD^a, Kai Hu, MD, Wolfgang Bauer, MD, Christoph Eilles, MD and Georg Ertl, MD

^a II.Medizinische Universitätsklinik, Klinikum Mannheim der Universität Heidelberg, Heidelberg, Germany
Medizinische Universitätsklinik Würzburg, Würzburg, Germany
Department of Nuclear Medicine, Universität Regensburg, Regensburg, Germany

View larger version (14K): [in a new window]   Figure 1 Cummulative survival curves for all patients in the study (solid line, n = 134), for patients without left ventricular dilation (solid bar, n = 97) and for patients with left ventricular dilation (dotted line, n = 37). Mortality was significantly (p = 0.00018) higher in patients with left ventricular dilation (32%) compared with patients who did not show left ventricular dilation (5%).

View larger version (31K): [in a new window]   Figure 2 (A) Shows that end-diastolic volume increased significantly and progressively and in nonsurvivors more than in it did in survivors. Left ventricular ejection fraction was decreased in nonsurvivors (B). Stroke volume index increased in survivors while it was depressed in nonsurvivors except at four weeks after infarction (C). (D) Shows that QTc duration decreased at and after 0.5 years after myocardial infarction in survivors but increased in nonsurvivors. QTc dispersion was decreased in survivors versus nonsurvivors (E). Lown score in survivors remained unchanged over time (F). Lown score significantly increased in nonsurvivors. Lown score 1 to 7 denotes: Lown grade 0; I; II; IIIa; IIIb; IVa; IVb. Values are mean ± SEM. The horizontal dashed lines indicate the upper (A,D,E) or lower (B,C) limit of normal for the respective value.

View larger version (33K): [in a new window]   Figure 3 Maximum and minimum heart rate (A) and mean heart rate in survivors and nonsurvivors (B).