Background:Because no data were available regarding the effect of preexisting left ventricular filling pressure (LVFP) on clinical outcomes in patients with acute myocardial infarction (AMI), we evaluated whether preexisting high LVFP can determine outcomes of subsequent AMI events.

Methods and Results:Among 399,613 subjects who underwent echocardiography for various reason from August 2004 to June 2019, 231 had experienced subsequent AMI and were stratified according to preexisting LVFP: low LVFP (E/e’ ≤14) and high LVFP (E/e’ >14). The primary outcome was cardiac death at 30 days and 1 year after AMI. Overall, 19.5% had high LVFP prior to AMI events. Preexisting high LVFP was associated with an increased risk of cardiac death at 30 days (3.8% vs. 11.6%; adjusted hazard ratio (HR) 4.56, 95% confidence interval (CI) 1.20–17.24, P=0.026) and 1 year after AMI (7.9% vs. 35.9%; adjusted HR 4.14, 95% CI 1.79–9.57, P<0.001). Preexisting E/e’ as a continuous value was significantly associated with 1-year risk of cardiac death (adjusted HR 1.08, 95% CI 1.02–1.15, P=0.007). Follow-up echocardiography showed that patients with high LVFP did not show improvement in systolic or diastolic function.

Conclusions:Preexisting high LVFP was associated with poor clinical course and 1-year cardiac death after subsequent AMI, as well as no improvement in systolic or diastolic function.

背景：由于没有关于先前存在的左心室充盈压（LVFP）对急性心肌梗死（AMI）患者临床结果影响的数据，我们评估了先前存在的高 LVFP 是否可以决定后续 AMI 事件的结果。

方法和结果： 2004年8月至2019年6月期间因各种原因接受超声心动图检查的399,613名受试者中，231名受试者随后发生AMI，并根据先前存在的LVFP进行分层：低LVFP（E/e'≤14）和高LVFP（E/e） '>14)。主要结局是 AMI 后 30 天和 1 年的心源性死亡。总体而言，19.5% 的人在 AMI 事件之前具有高 LVFP。先前存在的高 LVFP 与 30 天时心源性死亡风险增加相关（3.8% vs. 11.6%；调整后风险比 (HR) 4.56，95% 置信区间 (CI) 1.20–17.24，P=0.026）和 1 年后AMI（7.9% vs. 35.9%；调整后 HR 4.14，95% CI 1.79–9.57，P<0.001）。先前存在的 E/e' 作为连续值与 1 年心源性死亡风险显着相关（调整后 HR 1.08，95% CI 1.02–1.15，P=0.007）。随访超声心动图显示，高 LVFP 患者的收缩或舒张功能并未出现改善。

结论：先前存在的高 LVFP 与随后的 AMI 后不良临床病程和 1 年心源性死亡有关，并且收缩或舒张功能没有改善。