Wall motion score index and ejection fraction for risk stratification following acute myocardial infarction.

J. E. Moller, Graham Scott Hillis, J. K. Oh, G. S. Reeder, B. J. Gersh, P. A. Pellikka

    Research output: Contribution to journalArticle

    137 Citations (Scopus)

    Abstract

    Background The prognostic importance of regional systolic function, as assessed by wall motion score index (WMSI), compared with global function, as assessed by left ventricular ejection fraction (LVEF), has not been assessed in large populations after acute myocardial infarction.

    Methods Echocardiograms, including the assessment of WMSI and LVEF, were performed in 767 patients with acute myocardial infarction at a median of 1 day (25th and 75th percentiles 0-2 days) after admission. Patients were followed for a median of 19 months (range 12-28 months). Cox proportional hazards models were constructed for the primary study end point (all-cause mortality) and for a secondary end point (hospitalization for congestive heart failure).

    Results During follow-up (median 40 months; range 32-50 months), 216 patients died and 54 patients were hospitalized for congestive heart failure. By univariate analysis, both LVEF (P <.0001) and WMSI (P <.0001) were powerful predictors of all-cause mortality. By a forward conditional Cox model, WMSI proved to be an independent predictor of death (hazard ratio 1.15 per 0.2-unit increase, 95% CI 1.10-1.21, P <.0001). When WMSI was included in the model, LVEF did not provide additional prognostic information (P =.77). Wall motion score index also proved to be an independent predictor of hospitalization for congestive heart failure (hazard ratio 1.21 per 0.2-unit increase, 95% CI 1.07-1.37, P =.002), whereas LVEF did not (P =.56).

    Conclusion Both LVEF and WMSI provide powerful prognostic information after acute myocardial infarction; however, the predictive power of WMSI is greater.

    Original languageEnglish
    Pages (from-to)419-425
    Number of pages6
    JournalAmerican Heart Journal
    Volume151
    DOIs
    Publication statusPublished - 2006

    Keywords

    • LEFT-VENTRICULAR DYSFUNCTION
    • THROMBOLYTIC THERAPY
    • RADIONUCLIDE ANGIOGRAPHY
    • ECHOCARDIOGRAPHY
    • MORTALITY
    • DETERMINANTS
    • HYPERKINESIA
    • SURVIVAL
    • TRIAL

    Cite this

    Wall motion score index and ejection fraction for risk stratification following acute myocardial infarction. / Moller, J. E.; Hillis, Graham Scott; Oh, J. K.; Reeder, G. S.; Gersh, B. J.; Pellikka, P. A.

    In: American Heart Journal, Vol. 151, 2006, p. 419-425.

    Research output: Contribution to journalArticle

    Moller, J. E. ; Hillis, Graham Scott ; Oh, J. K. ; Reeder, G. S. ; Gersh, B. J. ; Pellikka, P. A. / Wall motion score index and ejection fraction for risk stratification following acute myocardial infarction. In: American Heart Journal. 2006 ; Vol. 151. pp. 419-425.
    @article{06212dd633d64970883663bc033930b5,
    title = "Wall motion score index and ejection fraction for risk stratification following acute myocardial infarction.",
    abstract = "Background The prognostic importance of regional systolic function, as assessed by wall motion score index (WMSI), compared with global function, as assessed by left ventricular ejection fraction (LVEF), has not been assessed in large populations after acute myocardial infarction.Methods Echocardiograms, including the assessment of WMSI and LVEF, were performed in 767 patients with acute myocardial infarction at a median of 1 day (25th and 75th percentiles 0-2 days) after admission. Patients were followed for a median of 19 months (range 12-28 months). Cox proportional hazards models were constructed for the primary study end point (all-cause mortality) and for a secondary end point (hospitalization for congestive heart failure).Results During follow-up (median 40 months; range 32-50 months), 216 patients died and 54 patients were hospitalized for congestive heart failure. By univariate analysis, both LVEF (P <.0001) and WMSI (P <.0001) were powerful predictors of all-cause mortality. By a forward conditional Cox model, WMSI proved to be an independent predictor of death (hazard ratio 1.15 per 0.2-unit increase, 95{\%} CI 1.10-1.21, P <.0001). When WMSI was included in the model, LVEF did not provide additional prognostic information (P =.77). Wall motion score index also proved to be an independent predictor of hospitalization for congestive heart failure (hazard ratio 1.21 per 0.2-unit increase, 95{\%} CI 1.07-1.37, P =.002), whereas LVEF did not (P =.56).Conclusion Both LVEF and WMSI provide powerful prognostic information after acute myocardial infarction; however, the predictive power of WMSI is greater.",
    keywords = "LEFT-VENTRICULAR DYSFUNCTION, THROMBOLYTIC THERAPY, RADIONUCLIDE ANGIOGRAPHY, ECHOCARDIOGRAPHY, MORTALITY, DETERMINANTS, HYPERKINESIA, SURVIVAL, TRIAL",
    author = "Moller, {J. E.} and Hillis, {Graham Scott} and Oh, {J. K.} and Reeder, {G. S.} and Gersh, {B. J.} and Pellikka, {P. A.}",
    year = "2006",
    doi = "10.1016/j.ahj.2005.03.042",
    language = "English",
    volume = "151",
    pages = "419--425",
    journal = "American Heart Journal",
    issn = "0002-8703",
    publisher = "Mosby Inc.",

    }

    TY - JOUR

    T1 - Wall motion score index and ejection fraction for risk stratification following acute myocardial infarction.

    AU - Moller, J. E.

    AU - Hillis, Graham Scott

    AU - Oh, J. K.

    AU - Reeder, G. S.

    AU - Gersh, B. J.

    AU - Pellikka, P. A.

    PY - 2006

    Y1 - 2006

    N2 - Background The prognostic importance of regional systolic function, as assessed by wall motion score index (WMSI), compared with global function, as assessed by left ventricular ejection fraction (LVEF), has not been assessed in large populations after acute myocardial infarction.Methods Echocardiograms, including the assessment of WMSI and LVEF, were performed in 767 patients with acute myocardial infarction at a median of 1 day (25th and 75th percentiles 0-2 days) after admission. Patients were followed for a median of 19 months (range 12-28 months). Cox proportional hazards models were constructed for the primary study end point (all-cause mortality) and for a secondary end point (hospitalization for congestive heart failure).Results During follow-up (median 40 months; range 32-50 months), 216 patients died and 54 patients were hospitalized for congestive heart failure. By univariate analysis, both LVEF (P <.0001) and WMSI (P <.0001) were powerful predictors of all-cause mortality. By a forward conditional Cox model, WMSI proved to be an independent predictor of death (hazard ratio 1.15 per 0.2-unit increase, 95% CI 1.10-1.21, P <.0001). When WMSI was included in the model, LVEF did not provide additional prognostic information (P =.77). Wall motion score index also proved to be an independent predictor of hospitalization for congestive heart failure (hazard ratio 1.21 per 0.2-unit increase, 95% CI 1.07-1.37, P =.002), whereas LVEF did not (P =.56).Conclusion Both LVEF and WMSI provide powerful prognostic information after acute myocardial infarction; however, the predictive power of WMSI is greater.

    AB - Background The prognostic importance of regional systolic function, as assessed by wall motion score index (WMSI), compared with global function, as assessed by left ventricular ejection fraction (LVEF), has not been assessed in large populations after acute myocardial infarction.Methods Echocardiograms, including the assessment of WMSI and LVEF, were performed in 767 patients with acute myocardial infarction at a median of 1 day (25th and 75th percentiles 0-2 days) after admission. Patients were followed for a median of 19 months (range 12-28 months). Cox proportional hazards models were constructed for the primary study end point (all-cause mortality) and for a secondary end point (hospitalization for congestive heart failure).Results During follow-up (median 40 months; range 32-50 months), 216 patients died and 54 patients were hospitalized for congestive heart failure. By univariate analysis, both LVEF (P <.0001) and WMSI (P <.0001) were powerful predictors of all-cause mortality. By a forward conditional Cox model, WMSI proved to be an independent predictor of death (hazard ratio 1.15 per 0.2-unit increase, 95% CI 1.10-1.21, P <.0001). When WMSI was included in the model, LVEF did not provide additional prognostic information (P =.77). Wall motion score index also proved to be an independent predictor of hospitalization for congestive heart failure (hazard ratio 1.21 per 0.2-unit increase, 95% CI 1.07-1.37, P =.002), whereas LVEF did not (P =.56).Conclusion Both LVEF and WMSI provide powerful prognostic information after acute myocardial infarction; however, the predictive power of WMSI is greater.

    KW - LEFT-VENTRICULAR DYSFUNCTION

    KW - THROMBOLYTIC THERAPY

    KW - RADIONUCLIDE ANGIOGRAPHY

    KW - ECHOCARDIOGRAPHY

    KW - MORTALITY

    KW - DETERMINANTS

    KW - HYPERKINESIA

    KW - SURVIVAL

    KW - TRIAL

    U2 - 10.1016/j.ahj.2005.03.042

    DO - 10.1016/j.ahj.2005.03.042

    M3 - Article

    VL - 151

    SP - 419

    EP - 425

    JO - American Heart Journal

    JF - American Heart Journal

    SN - 0002-8703

    ER -