Left ventricle dysfunction and its determinants in patients with ST-segment elevation acute myocardial infarction
The article discusses the echocardiographic parameters characterizing the violation of contractility and diastolic properties of the left ventricular myocardium in patients with ST-segment elevation acute myocardial infarction evaluated in a prospective study. In case of effective revascularization and thrombolysis, the prevalence of diastolic dysfunction with a preserved or moderately reduced systolic dysfunction is observed. Under these conditions, the use of the widespread parameter of the left ventricular ejection fraction, which characterizes the degree of shortening of the myocardial fibers, is not informative. Tissue dopplerography of the mitral annulus makes it possible to evaluate the global contractility of the left ventricle and its diastolic properties. The closest significant correlations with the determinants of myocardial damage (markers of necrosis and inflammatory activity) were obtained for the myocardial performance index, which justifies the clinical value of this index as an integral parameter that reliably reflects both types of myocardial dysfunction.