Abstract
Aims: To investigate the association between intima-media thickness of brachial and common carotid arteries and factors of the coagulation- and fibrinolysis system with diastolic dysfunction in patients with a previous myocardial infarction.
Patients and methods: One hundred and five patients, men (72 %) and women (28%) aged between 32-73 years with a history of previous acute myocardial infarction were included. An age-matched control group with no cardiovascular risk factors was used as a comparison. B-mode ultrasound of common carotid and brachial arteries and echocardiography were evaluated in all subjects. Calculated intima-media area (cIMa) of the common carotid and brachial arteries and tissue Doppler imaging (TDI) were examined. Factors of the coagulation- and fibrinolysis system were also measured.
Results: Prothrombin fragment 1+2 was significantly higher in patients with previous myocardial infarction compared to the control group (P<0.01). Early diastolic filling peak velocity (E´-v) and late diastolic filling peak velocity (A´-v) was significantly lower among patients with previous myocardial infarction than in the control group (P<0.01 respectively P<0.001). Late diastolic filling peak time was significantly and positively associated with log Prothrombin fragment 1+2 (P<0.001), calculated common carotid cIMa (P<0.02), systolic blood pressure (P<0.01) and to IMT of brachial artery (P<0.02) in patients with a previous MI. In stepwise multiple regression analysis, log Prothrombin fragment 1+2 remained the only variable with independent significant correlation to late diastolic filling peak time.
Conclusions: Diastolic dysfunction is correlated to cIMa of common carotid and brachial arteries, systolic blood pressure and Prothrombin fragment 1+2 in patients with myocardial infarction. Thus, atherosclerosis, diastolic dysfunction and coagulopathy are tightly interrelated disorders in patients with myocardial infarction.