[Evaluation and proposal of a classification for ventricular systolic interdependence with atrioventricular plane displacement in patients with first acute myocardial infarct]. / Interdependencia ventricular sistólica con el desplazamiento del plano auriculoventricular en pacientes con primer infarto del miocardio. Evaluación y propuesta de clasificación.

ABSTRACT

OBJECTIVE: Our objective was to evaluate and propose a classification of ventricular systolic interdependence with atrioventricular plane displacement (AVPD) in patients with acute myocardial infarction. MATERIAL AND METHODS: Eighty consecutive patients with first acute myocardial infarction event were studied. Two-dimensional- and M-mode echocardiogram were carried out. We measured the ejection fraction of both ventricles and the mitral and tricuspid AVPD. According to the acute myocardial infarction localization, patients were divided into three groups group I inferior or postero-inferior, group II anterior, and group III postero-inferior with right ventricle involvement. RESULTS: Eighty patients with first acute myocardial infarction were studied, 64 men and 16 women; the age average was 62 +/- 12.5 years. In group I there were 17 cases, in group II, 45 and in group III, 18. The left ventricular ejection fraction was, respectively, 50.3% +/- 11.1%, 37.7 +/- 8.6%, and 38.3 +/- 8.2% for groups I, II, and III (p <0.0001); the mitral AVPD was, respectively, 12.7 +/- 3.2 mm, 11.2 +/- 2.9 mm, and 9.9 +/- 2.7 mm (p = 0.024); the right ventricular ejection fraction was, respectively, 53.5 +/- 7.1%, 54.4 +/- 9% and 35.5 +/- 8.7% (p < 0.0001) and the tricuspid AVPD was, respectively, 20.1 +/- 3.6 mm, 19.9 +/- 4.6 mm, and 12.5 +/- 5.7 mm (p < 0.0001). With the above-mentioned results, we propose a ventricular systolic interdependence classification A for group I (biventricular function preserved), B for group II (left damage and compensation of the right one), and C for group III (biventricular damage). CONCLUSIONS: The assessment of the ejection fraction of both ventricles and the mitral and tricuspid AVPD can evaluate the ventricular systolic interdependence and with these parameters we propose a classification with possible prognostic implications.