Conclusions: During STEMI, contrary to findings in stable patients, the predominant Doppler manifestation of the severe diastolic dysfunction and elevated LVEDP was an abnormal relaxation mitral inflow pattern accompanied by E/E' ratios of 8–15. Serial Doppler assessment suggests incomplete diastolic recovery following STEMI.
Despite the presence of severe diastolic dysfunction and elevated LVEDP, the predominant mitral inflow pattern during acute STEMI was an abnormal relaxation pattern (E/A ratio < 1). This is accompanied by only modestly reduced TDI-derived early diastolic velocities (E'), obtained from the mitral annulus, resulting in observed E/E' ratios in the indeterminate range 8–15 in the majority of patients. Furthermore, serial tissue Doppler assessment shows persistence of diastolic dysfunction at 3 days and then at 1 year follow-up despite successful revascularization.
Na fase aguda do Infarto a perda de área contrátil é compensada parcialmente pelo aumento da frequencia cardíaca. O enchimento ventricular as custas de pressões atriais elevadas vai se instalando gradualmente. O Eco mostra tudo!