Skip to main content
Log in

Haemodynamic patterns in ST-elevation myocardial infarction: incidence and correlates of elevated filling pressures

  • original article
  • Published:
Netherlands Heart Journal Aims and scope Submit manuscript

Abstract

Objectives. We sought to study the incidence and clinical correlates of elevated filling pressures in ST-elevation myocardial infarction (STEMI) patients, without physical signs of heart failure and treated with primary coronary angioplasty.

Background. Haemodynamic data, as measured with a Swan-Ganz catheter, are not routinely obtained in STEMI patients. At admission, low blood pressure, increased heart rate, sweating, increased respiration rate, rales, oedema, and a third heart sound are indicative of heart failure.

Methods. All consecutive STEMI patients were monitored by a Swan-Ganz catheter and central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressure (PAS) and cardiac index (CI) were measured. To investigate the clinical correlates of the haemodynamic status patients were classified according to previously defined haemodynamic criteria.

Results. We studied 90 patients, aged 60.5±13.1 year, 76% were male. Mortality at 30 days was 2/90 (2.2%). Patients with impaired haemodynamics presented later and had larger myocardial infarct sizes. CVP, PCWP and PAS were above normal in 36 (40%) patients.

Conclusion. A large proportion of STEMI patients without physical signs of heart failure have elevation of right- as well as left-sided cardiac filling pressures. (Neth Heart J 2007:15:95-9.)

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Grines CL, Browne KF, Marco J, Rothbaum D, Stone GW, O’Keefe J, et al. A comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction. The Primary Angioplasty in Myocardial Infarction Study Group. N Engl J Med 1993;328:673-9.

    Google Scholar 

  • Zijlstra F, de Boer MJ, Hoorntje JC, Reiffers S, Reiber JH, Suryapranata H. A comparison of immediate coronary angioplasty with intravenous streptokinase in acute myocardial infarction. N Engl J Med 1993;328:680-4.

    Google Scholar 

  • Bednar F, Widimsky P, Krupicka J, Groch L, Ashermann M, Zelizko M; PRAGUE Study Group Investigators. Interhospital transport for primary angioplasty improves the long-term outcome of acute myocardial infarction compared with immediate thrombolysis in the nearest hospital (one-year follow-up of the PRAGUE-1 study. Can J Cardiol 2003;19:1119-22.

    Google Scholar 

  • Zijlstra F, Hoorntje JCA, de Boer MJ, Reiffers S, Miedema K, Ottervanger J, et al. Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acute myocardial infarction. N Engl J Med 1999;341:1413-9.

    Google Scholar 

  • Ernst NMSKJ, Timmer JR, Zijlstra F, van ’t Hof AWJ; Zwolle Myocardial Infarction Study Group. Impact of Failed Mechanical Reperfusion in Patients With Acute Myocardial Infarction Treated With Primary Angioplasty. Am J Cardiol 2005;96:332-4.

    Google Scholar 

  • Henriques JP, Zijlstra F, De Boer MJ, van ’t Hof AW, Gosselink AT, Dambrink JH, et al. The prognostic importance of heart failure and age in patients treated with primary angioplasty. Eur J Heart Fail 2003;5:291-4.

    Google Scholar 

  • Killip T 3rd, Kimball JT. Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. Am J Cardiol 1967;20:457-64.

    Google Scholar 

  • Van der Horst IC, Timmer JR, Ottervanger JP, Bilo HJ, Gans RO, de Boer MJ, et al.; GIPS investigators. Glucose-insulin-potassium and reperfusion in acute myocardial infarction: rationale and design of the Glucose-Insulin-Potassium Study-2 (GIPS-2). Am Heart J 2005;149:585-91.

    Google Scholar 

  • Bergstra A, Svilaas T, van den Heuvel AFM, van der Horst ICC, Zijlstra F. Glucose-insulin-potassium infusion in acute myocardial infarction: A hemodynamic study. Am Heart J 2006;151:345-1.

    Google Scholar 

  • Bergstra A, van Dijk RB, Hillege HL, Lie KI, Mook GA. Assumed oxygen consumption based on calculation from dye dilution cardiac output: an improved formula. Eur Heart J 1995;16:698-03.

    Google Scholar 

  • DuBois D, DuBois EF. Clinical calorimetry. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 1916;17:863-71.

    Google Scholar 

  • Zimlichman R, Mossinson D, Ovsyshcher IE. Assessment of hemodynamic changes in the early phase of uncomplicated acute myocardial infarction. Int J Cardiol 1989;25:303-11.

    Google Scholar 

  • Lorente P, Kedra W, Masquet C, Azancot I, Beaufils P. Relationship between hemodynamic profiles and topography of acute myocardial infarction. Eur J Cardiol 1979;10:19-35.

    Google Scholar 

  • Kostuk W, Barr JW, Simon AL, Ross Jr J. Correlations between the chest film and hemodynamics in acute myocardial infarction. Circulation 1973;48:624-32.

    Google Scholar 

  • Murray DP, Watson RDS, Zezulka AV, Murray RG, Littler WA. Plasma cathecholamine levels in acute myocardial infarction: influence of beta-adrenergic blockade and relation to central hemodynamics. Am Heart J 1988;115:38-44.

    Google Scholar 

  • Murray DP, Murray M, Rafiqi E, Littler WA. Does acute-phase beta-blockade reduce mortality in acute myocardial infarction by limiting infarct size? Int J Cardiol 1988:20:327-39.

    Google Scholar 

  • Ehrich DA, Biddle TL, Kronenberg MW, Yu PN. The hemodynamic response to intra-aortic balloon counterpulsation in patients with cardiogenic shock complicating acute myocardial infarction. Am Heart J 1977;93:274-9.

    Google Scholar 

  • Lorente P, Gourgon R, Beaufils P, Masquet C, Rosengarten M, Azancot I, et al. Multivariate statistical evaluation of intraaortic counterpulsation in pump failure complicating acute myocardial infarction. Am J Cardiol 1980;46:124-34.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands

Correspondence to: A.F.M. van den Heuvel Department of Cardiology, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, the Netherlands

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bergstra, A., Svilaas, T., van Veldhuisen, D.J. et al. Haemodynamic patterns in ST-elevation myocardial infarction: incidence and correlates of elevated filling pressures. NHJL 15, 95–99 (2007). https://doi.org/10.1007/BF03085962

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03085962

Navigation