Evaluation of Systolic and Diastolic Function of Left Ventricle by Using Velocities of Mitral Annulus in Patients with First Acute Anterior MI and Their one Month Follow up

Background: To evaluate systolic and diastolic dysfunction of left ventricle in patients with first anterior myocardial infarction and its relation to one month mortality after myocardial infarction; in this study mitral annulus motion velocity that was recorded by Tissue Doppler Imaging (TDI). Methods: The study included 111 consecutive individuals, 81 patients with first anterior myocardial infarction, (in wich 72 patients who survived and 9 patients dead one month after admission), 30 individuals which matched with the studying group selected as a control group. Longitudinal function of left ventricle was evaluated by the use of mitral annular velocities in this study. Results: Patients with myocardial infarction showed significant reduction in peak systolic, early diastolic and late diastolic annular mitral velocities comparing with control group in all studied segments. There was a good correlation between Left Ventricle Ejection Fraction (LVEF) and all mitral valve annular velocities. Also Myocardial Performance Index (MPI) more than 0.8 and (Regional Wall Motion Scoring Index (RWMSI) more than 1.77 had high sensitivity (0.94 and 0.96 respectively) in predicting death in follow-up period. Conclusion: Reduced peak systolic mitral annulus velocity is an expression of regionally reduced systolic function. Reduced peak early and late diastolic velocities reflect regional diastolic dysfunction. Also Regional wall motion score index and myocardial performance index can be useful in predicting death after myocardial infarction.