Central haemodynamics in acute myocardial infarction in relation to mortality and peak enzyme activity
Held, P.H.; Corbeij, H.M.; Dunselman, P.; Hjalmarson, A.; Murray, D.; Swedberg, K.
European Heart Journal 7(6): 475-481
1986
ISSN/ISBN: 0195-668X PMID: 3732297 Document Number: 272733
The relation of central haemodynamic changes to subsequent mortality and peak enzyme activity was investigated in 190 patients with acute myocardial infarction. The mean delay time from onset of symptoms to the haemodynamic study was 7.2 hours. Major exclusion criteria were heart rate < 65 beats min-1, systolic blood pressure < 105 mm Hg and lung rates to a distance of > 10 cm above the lung bases. Nine patients (4.7%) died within 15 days and 16 patients (8.4%) within 90 days after the infarction. Compared to survivors, non-survivors were characterized by baseline depression of cardiac index, stroke volume index and left ventricular stroke work index, while pulmonary capillary wedge pressure and peripheral resistance were increased. However, a wide overlap between survivors and non-survivors makes the predictive value low in the individual patient. Peak serum aspartate aminotransferase (S-ASAT) activity was weakly related to baseline pulmonary capillary wedge pressure (r=0.28; P < 0.001) and stroke volume index (r=-0.22; P < 0.01). The correlation to pulmonary capillary wedge pressure was only found in anterior (r=-0.34) infarcts. Peak serum lactate dehydrogenase (LD1) was not correlated with baseline haemodynamics.