Carasso et al used echocardiography to evaluation patients following acute myocardial infarction (AMI). These findings can help to identify a patient with an increased 30-day mortality rate. The authors are from Chaim Selba Medical Center, Tel Aviv University and the Echocardiography Working Group of the Israel Heart Society.


Echocardiography parameters:

(1) left ventricular ejection fraction (LVEF)

(2) mitral valve regurgitation

(3) left ventricular filling pressure

(4) pulmonary artery systolic pressure in mm Hg


A patient was considered high risk (30-day mortality rate 14%) if any of the followiig are present:

(1) LVEF < 30%

(2) mitral valve regurgitation severe

(3) LV filling pressure restrictive

(4) pulmonary artery systolic pressure > 60 mm Hg


A patient was considered intermediate risk (30-day mortality rate 4%) if any of the followiig are present:

(1) LVEF 30 to 39%

(2) mitral valve regurgitation moderate

(3) LV filling pressure impaired relaxation

(4) pulmonary artery systolic pressure 46 to 60 mm Hg


Anyone not moderate or high risk is low risk (30-day mortality rate 1%).


30-day mortality was higher if the patient is or has:

(1) older (hazard ratio 1.3 per 10 years)

(2) female (hazard ratio 2.1)

(3) Killip class II to IV on admission (hazard ratio 3.1)

(4) has moderate or high risk echocardiography features (hazard ratios 2.9 and 8.2 respectively)


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