Predictive Value of Myocardial Performance Index for Cardiac Events in Patients Hospitalized for First Myocardial Infarction

We sought to assess the ability of The Myocardial Performance Index (MPI), measured at entry, to predict in-hospital cardiac adverse events in a series of patients with first Acute Myocardial Infarction (AMI). A complete 2-dimential and Doppler echocardiographic examination was performed within 24 h of arrival at the coronary care department in 78 patients (61 men and 17 women; mean age 58±2 years) with first AMI. Patients were divided later into 2 groups according to their in-hospital course: group 1 comprised 46 patients with an uneventful course and group 2 comprised 32 patients with a complicated in-hospital course (death, heart failure, arrhythmias, post-AMI angina or Re MI). There were no significant differences between the 2 groups with regard to history of hypertension, diabetes mellitus, hypercholesterolemia, cardiac enzymes and response to thrombolytic, however patients with lateral MI more commonly had events (26 vs. 15%; p= 0.01) and those who received thrombolytic had less events (32 vs. 66%; p=0.01). Echocardiographic findings showed significant difference in Left Ventricle Ejection Fraction (LVEF) (40±8% vs. 33±2%; p=0.005) between two groups; however, MPI showed no significant difference between two groups (0.50±0.14 vs. 0.47±0.16; p= 0.43) and we did not find any cut point with acceptable sensitivity and specificity for predicting in-hospital complications. E wave acceleration time at 91ms showed a sensitivity of 87 and specificity of 78 and in factor analysis the component comprising of LVEF, Left Ventricle End-Systolic Diameter (LVESD), ratio of early to late peak velocities (E/A), E-wave Deceleration Time (EDT), Isovolumic Relaxation Time (IVRT) showed sensitivity of 87 and specificity of 67%. Our findings suggest that in the acute phase of AMI, the MPI measured in admission cannot be a useful to predict which patients are at high risk for in-hospital cardiac events.