International Journal of Medical and Health Research

Authors
Sasikumar Perumal, Sureshkumar Krishnan, Ravikumar Padmanaban, Ravikumar Padmanaban, Karthick Kuppan, Shankar Radhakrishnan

Abstract
Background: The overall cardiovascular mortality in India is increasing with an increase in the incidence and prevalence of heart failure. In recent years, LV diastolic dysfunction has been related to development of heart failure, progressive LV dilatation, and mortality after myocardial infarction. Pulsed Doppler echocardiography has become well accepted as a reliable and useful non-invasive method for assessment of LV diastolic function. Mitral and pulmonary venous flow velocities assessed by Doppler are used for the evaluation of LV filling pressure, relaxation, and chamber stiffness in establishing diagnosis and prognosis. Aim: To assess the left ventricular diastolic function among post MI patients using echocardiogram. Methodology: A cross-sectional study was conducted for a period of one year in the medicine department at Dharmapuri medical college hospital. Patients with a history of previous episode of myocardial infarction in the age group of 30 – 55 years were included in the study. Patients with known history of diabetes and hypertension were excluded from the study. A total of 220 patients with the above mentioned inclusion criteria were enrolled for our study. All the basic blood and urine examination was conducted to assess their sugar levels, renal functions and the lipid parameters. ECG was taken for all the subjects. Two-dimensional echocardiography was videotaped by use of the parasternal long-axis view, multiple short-axis views, and apical 2-,4-, and long-axis views. The systolic and diastolic functions were assessed using the echocardiogram. Results: Among the various site of infarct inferior wall followed by anterior wall MI were found to be more common among the study subjects and in 18% of the patients there was a combination of both anterior and lateral wall and anterior and inferior wall MI. In our study among the 220 patients 65 patients showed features of diastolic dysfunction in echocardiogram with a prevalence of 29.5% among which type I dysfunction found to be more common followed by type II and only one patient had type IV diastolic dysfunction. Conclusion: The prevalence of diastolic dysfunction is much more common than the systolic dysfunction among the coronary artery disease patients and it is increasing among elderly. Echocardiography being a non-invasive and cost-effective tool compared to angiogram or other radioisotope studies can be used periodically among the post MI patients to identify the diastolic dysfunction at an early stage and plan appropriate interventions.