CORRELATION OF MYOCARDIAL PERFORMANCE INDEX ASSESSED BY DIFFERENT ECHOCARDIOGRAPHIC METHODS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION RECEIVING DIFFERENT REPERFUSION TREATMENT

Abstract

Background: It is claimed that the myocardial performance index (MPI), a Doppler-derived assessment of combined systolic and diastolic myocardial performance, helps assess the prognosis following acute myocardial infarction (AMI). This study aimed to compare MPI scores obtained using various echocardiographic techniques in acute MI patients receiving various reperfusion treatments. Methods: This prospective cohort observational study was executed on 100 patients with acute ST elevation MI. Patients were divided into three groups according to the kind of reperfusion strategy: group I: 50 patients with 1st attack of acute ST elevation MI treated with PPCI, group II: 25 patients treated with fibrinolytic therapy and group III: 25 patients treated with pharmaco-invasive strategy. Results: When revascularization was delayed more than 3 hours, primary PCI was better than thrombolytic therapy and pharmaco-invasive strategy with no difference between thrombolytic and pharmaco-invasive strategies in (EF) and MPI, but in diastolic dysfunction (DD) was insignificantly different among the three studied groups. There was an insignificant difference between MPI acquired by pulsed wave doppler (PWD) or tissue doppler imaging (TDI) in each group p>0.05. Conclusions: MPI and EF are covariates that are affected by time and method of reperfusion, so in case the time of reperfusion was less than three hours, there was no difference according to the method of reperfusion, but when the time of reperfusion was delayed for more than three hours, PPCI was much better in decreasing post-MI heart failure (HF) or left ventricular (LV) dysfunction than thrombolytic and pharmaco-invasive strategies.