Spontaneous Changes in Hemodynamics in Uncomplicated Acute Myocardial Infarction: a Prospective Echocardiographic Study

Abstract

Spontaneous changes in heart rate (HR), systolic and diastolic blood pressure, left ventricular end-diastolic dimension (LVEDD), and left ven tricular end-systolic dimension (LVESD) over a 95-minute period were evaluated in 13 patients with uncomplicated myocardial infarction within 48 hours of infarction. The patients were on no medication at the time of their study. ECGs, blood pressures, and echocardiograms were recorded every 1 minute for 5 minutes (control period) and 1, 3, 5, 10, 20, 30, 45, 60, and 90 minutes (study period) after the control measurements. The mean control LVEDD was 57.4 ± 10.0 mm; the standard deviation (SD) across the control values was 0.9 mm. The mean LVEDD during the 90-minute study period was 57.5 ± 9.7 mm; the SD across the 90-minute study period values was 1.4 mm. The mean control LVESD was 48.3 ± 11.4 mm; the SD across the control value was 1.0 mm. The mean LVESD during the 90-minute study period was 48.9 ± 11.0 mm; the SD across the 90-minute study period was 1.7 mm. No significant differences in HR, systolic or diastolic blood pressure, LVEDD, and LVESD occurred be tween the 5 control values and the 10 values obtained during the 90- minute study period in the 13 patients in this study. We conclude that (1) reproducible measurements of LVEDD and LVESD can be obtained by echocardiography in stable patients with uncomplicated acute myocardial infarction over a 95-minute period; and (2) the hemodynamic variables are stable in uncomplicated myocardial infarction over a 95-minute period.