Cardiac volume load and heart failure prognosis in patients with uncomplicated myocardial infarction

Abstract

То predict heart failure (HF) in 192 patients with Q-wave myocardial infarction (Q-MI), a brief cardiac volume load (VI) test was performed at MI Day 3. Group I included 50 patients with Q-MI and HF II (Killip) (n=50), Group II- 108 patients with Q-MI and no HF (left ventricular ejection fraction, IVEF >40 %), Group III - 34patients with Q-MI, no HF (IVEF>40 %), but with pathologic VI test reaction. These participants received alpha-blocking beta-blocker carvedilol instead ofmetoprolol. The control group included 20 healthy people. In controls, VI test was associated with improved IV systolic and diastolic functions (SF, DF); IV form became more ellipsoid (normal VI reaction). In Group I, VL test was associated with disturbances in SF and IV filling structure; IF form became more spheroid (pathologic reaction). In Group II, normal reaction was observed in 40 %, pathologic reaction - in 60 %. During one-year follow-up period, HF developed only in patients with pathologic VI reaction (28,1 %). long-term carvedilol therapy reduced HF incidence inpatients with uncomplicated Q-MI and pathologic VI reaction, from 28,1 % to 11,8 % (p<0,05).