Hemodynamic stratification using transthoracic echocardiography in patients with ST segment elevation acute myocardial infarction
DOI:
https://doi.org/10.24265/horizmed.2017.v17n2.07Keywords:
Hemodynamic stratification, Transthoracic echocardiography, Myocardial infarctionAbstract
Objective: To evaluate the feasibility of performing a hemodynamic stratification in patients with ST segment elevation acute myocardial infarction using transthoracic echocardiography.
Materials and methods: A descriptive, prospective and cross-sectional study that included 30 patients in sinus rhythm with ST segment elevation acute myocardial infarction, admitted to the coronary care unit of Hospital Edgardo Rebagliati Martins. Cardiac output, left ventricle filling pressure, systemic vascular resistance and pulmonary vascular resistance were estimated.
Results: The mean age was 67 ± 10.6 years old, with male predominance (86.7%). The estimation of cardiac output and left ventricle filling pressure was possible in 100% of the individuals. The systemic vascular resistance and pulmonary vascular resistance could be estimated in 29 (96.6%) and 28 (93.3%) patients, respectively. The hemodynamic stratification was as follows: stage I (normal): 18 patients (60%), stage II (congestive): 6 patients (20%), stage III (hypovolemia, RV infarction): 5 patients (16.7%) and stage IV (shock): 1 patient (3.3%).
Conclusions: It is concluded that a transthoracic echocardiographic hemodynamic stratification may be performed in the studied population.
Downloads
References
Forrester JS, Diamond G, Swan HJ. Correlative Classification of clinical and hemodynamic Function After Acute Myocardial Infarction. Am J Cardiol. 1977;39(2):137-45.
Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography. J Am Soc Echocardiogr. 2009;22(2):107-33.
Porter TR, Shillcutt SK, Adams MS, Desjardins G, Glas KE, Olson JJ, et al. Guidelines for the Use of Echocardiography as a Monitor for Therapeutic Intervention in Adults: A Report from the American Society of Echocardiography. J Am Soc Echocardiogr. 2015;28(1):40-56.
Nagueh SF, Smiseth OA, Appleton CP, Byrd BF, Dokainish H, Edvardsen T, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2016;29(4):277-314
Memtsoudis SG, Rosenberger P, Loffler M, Eltzschig HK, Mizuguchi A, Shernan SK, et al. The usefulness of transesophageal echocardiography during intraoperative cardiac arrest in non-cardiac surgery. Anesth Analg. 2006;102(6):1653-7.
Ritzema JL, Richards AM, Crozier IG, Frampton CF, Melton IC, Doughty RN, et al. Serial Doppler echocardiography and tissue Doppler imaging in the detection of elevated directly measured left atrial pressure in ambulant subjects with chronic heart failure. J Am Coll Cardiol Img 2011;4(9):927-34.
Lahm T, McCaslin CA, Wozniak TC, Ghumman W, Fadl YY, Obeidat OS, et al. Medical and surgical treatment of acute right ventricular failure. J Am Coll Card. 2010;56(18):1435-46.
Rydman R, Larsen F, Caidahl K, Alam M. Right ventricular function in patients with pulmonary embolism: early and late findings using Doppler tissue imaging. J Am Soc Echocardiogr. 2010;23(5):531-7.
Kohli-Seth R, Neuman T, Sinha R, Bassily-Marcus A. Use of echocardiography and modalities of patient monitoring of trauma patients. Curr Opin Anaesth. 2010;23(2):239-45.
Torres C. Evaluación de método ecocardiográfico para calcular presión diastólica final de ventrículo izquierdo en pacientes con enfermedad coronaria. Revista Peruana de Cardiogia. 2002;28(1):42-9.
Jáuregui M. Valor pronóstico de la velocidad de propagación del llenado ventricular en pacientes con infarto de miocardio con elevación del segmento ST. Revista Peruana de Cardiología. 2006;32(1):44-9.
Ríos JJ, Romero R. Determinación de la presión de llenado ventricular izquierdo por doppler tisular en pacientes con disfunción cardiaca sistólica y diastólica. Revista Peruana de Cardiología. 2007;33(1):16-9.
Lewis JF, Kuo LC, Nelson JG, Limacher MC, Quiñones MA. Pulsed Doppler Echocardiographic Determination of Stroke Volume and Cardiac Output: Clinical Validation of two new methods using the apical window. Circulation 1984;70(3):425-31.
Kircher BJ, Himelman RB, Schiller N.B. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol. 1990;66(4):493-6.
Nagueh S. Kopelen H. Zoghbi W. Relation of mean right atrial pressure to echocardiographic and Doppler parameters of right atrial and right ventricular function. Circulation. 1996; 93(6):1160-1169
Abbas AE, Fortuin FD, Schiller NB, Appleton CP, Moreno CA, Lester SJ. A simple method for noninvasive estimation of pulmonary vascular resistance. J Am Coll Cardiol 2003; 41(6):1021-7.
Himelman RB, Stulbarg M, Kircher B, Lee E, kee L, Dean N, et al. Noninvasive evaluation of pulmonary artery pressure during exercise by saline-enhanced doppler echocardiography in chronic pulmonary disease. Circulation. 1989;79(4):863-71.
Nagueh SF. Tissue doppler imaging for the assessment of left ventricular diastolic function. J Cardiovasc Ultrasound 2008;16(3):76-9.
Florio L, Vignolo G, Centurión R, Manfredi A, Cuña E. Factibilidad de la valoración hemodinámica ecocardiográfica no invasiva en la insuficiencia cardíaca crónica. Rev Ur Cardiol. 2006;21(2):117-23.
Pérez Cabrera D, Herrera A, Gómez García. Variables hemodinámicas para la valoración incruenta de la hemodinámica pulmonar. Corsalud. 2012;4(3).215-7.
Lester S, Tajik AJ, Nishimura RA, Oh J, Khandheria B, Seward J. Unlocking of diastolic function: Deciphering the Rosetta Stone 10 years later. J Am Coll Cardiol. 2008;51(7):679-89.
Hochman JS, Buller CE, Sleeper LA, Boland J, Dvazik V, Sanborn T, et al. Cardiogenic shock complicating acute myocardial infarction-etiologies, management and outcome: a report from the SHOCK trial Registry. J Am Coll Cardiol. 2000;36(3):1063-70.
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Horizonte Médico (Lima)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Horizonte Médico (Lima) (Horiz. Med.) journal’s research outputs are published free of charge and are freely available to download under the open access model, aimed at disseminating works and experiences developed in biomedical and public health areas, both nationally and internationally, and promoting research in the different fields of human medicine. All manuscripts accepted and published in the journal are distributed free of charge under the terms of a Creative Commons license – Attribution 4.0 International (CC BY 4.0).
