Nageswaran, P M (2006) A Comparative study of Myocardial performance index with Conventional Echo Cardiographic Parameters of Left Ventricular function in Acute ST Elevation Myocardial Infarction patients & Its role in predicting in Hospital Morbidity. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION : Echocardiography is the most readily available and commonly used non invasive diagnostic tool in cardiology, especially for the assessment of LV function. Cardio vascular disease is the second most common cause of death after communicable diseases in India. Coronary heart diseases accounts for more than 50% of cardiovascular disease deaths. STEMI occurrence is a fatal event in approximately 20 to 30% of patients. Nearly one third of death occurs within one hour are mainly due to ventricular arrhythmias. But the late mortality is mainly depended on LV function. Hence LV function assessment is an integral part of any patient with acute STEMI. LV function derangement can affect systolic function, diastolic function or both. Two – dimensional echocardiography is well suited for studies of systolic function, and Doppler echocardiography provides a noninvasive technique for the assessment of diastolic function. However these measurements are load-dependent and change with the location of the sample volume, rhythm, heart rate and quality of the image. Even though systolic and diastolic dysfunction often coexists, only a few Doppler echocardiography variables combine measurements of systolic and diastolic performance. Recently, a new echocardiographic index combining the measurements of diastolic and systolic performance was defined. It was proposed first by Tei Chuwa et al in 1995. In its short life span, it has been shown to demonstrate powerful prognostic value in significant heart diseases such as dilated cardiomyopathy, idiopathic pulmonary hypertension, cardiac amyloidosis and recently in myocardial infarction. TEI index has also got various other advantages compared to classical 2D and Doppler parameters such as not being influenced by changes in blood pressure, heart rate, sex and age and not appearing to be affected significantly by loading condition. AIMS : To assess the role of myocardial performance index in Acute STEMI patients. To evaluate the relationship between myocardial performance index and area of infarct. To assess the relationship between myocardial performance index and systolic, diastolic dysfunction in Acute STEMI patients. To evaluate the relationship of Myocardial performance index with clinical parameters. To assess the Prognostic value of Myocardial performance index in In hospital morbidity. To find out, Is there any correlation between Ejection fraction derived from Myocardial performance index by Lax et al formula and that obtained by conventional Method (modified Simpson’s method). CONCLUSION : The following conclusions were derived from our study: Myocardial performance index was found to be significantly elevated in myocardial infarction patients than in controls. Myocardial performance index elevation was found to be significantly more in anterior infarcts than in Inferior infarct patients. Myocardial performance index has got a good correlation with systolic as well as diastolic function parameters. While Myocardial performance index was found to have a significant inverse relationship with Ejection fraction, it was also found to have significant relationship with abnormalities in diastolic function parameters like Deceleration time, Isovolumic relaxation time and E/E’ ratio. Myocardial performance index has got a significant positive correlation with Killip class and Risk factors such as Hypertension, diabetes and smoking. Myocardial performance index was found to be significantly elevated in patients who developed in hospital complications like Heart failure, Post infarction angina than in patients who did not have any complications. Hence myocardial performance index can be used as a prognostic indicator for predicting out comes. There was significant underestimation of the Ejection fraction by Lax [et al.] formula using myocardial performance index when compared with the Ejection fraction by 2D method. Hence Ejection fraction estimation from myocardial performance index using Lax [et al.] formula needs further large-scale studies before it can be used for clinical purpose.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Myocardial performance index with Conventional Echo Cardiographic Parameters ; Left Ventricular function ; Acute ST Elevation ; Myocardial Infarction patients ; Hospital Morbidity ; Comparative study. |
| Subjects: | MEDICAL > Cardiology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 06 Jul 2017 01:36 |
| Last Modified: | 06 Jul 2017 10:00 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1058 |
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