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(Circulation. 1974;49:106.)
© 1974 American Heart Association, Inc.

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Hemodynamic Effects of Plasma Volume Expansion and Prognostic Implications in Acute Myocardial Infarction

H. LEON GREENE M.D.¹; DAVID T. KELLY M.D.¹; DEAN R. TAYLOR M.D.¹; BERTRAM PITT M.D.¹

¹ From the Johns Hopkins Hospital and The Johns Hopkins University, Baltimore, Maryland.

Nine of eleven patients studied within fifteen hours from the onset of acute myocardial infarction had an abnormal response to plasma volume expansion in that stroke volume did not increase when left ventricular filling pressure was elevated. In contrast, in five patients studied more than fifteen hours after myocardial infarction and in five control patients stroke volume was increased when left ventricular filling pressure was elevated by plasma volume expansion. All patients have been followed for a mean of five months, and no patient died of pump failure or had significant heart failure. Often the hemodynamic response to plasma volume expansion within fifteen hours after uncomplicated acute myocardial infarction is abnormal, but it is not useful in predicting prognosis. The abnormal hemodynamic response may be transient, improving during early convalescence. It represents an interaction between left ventricular compliance and function, both of which may be changing rapidly early after acute myocardial infarction.

Key Words: Compliance • Starling's law • Left ventricular dysfunction

Submitted on June 14, 1973
Accepted on August 20, 1973