급성 심근경색후 좌심실 기능과 용적의 변화

심완주(Wan Joo Shim),안태훈(Tae Hoon Ahn),김영훈(Young Hoon Kim),노영무(Young Moo Ro) 대한내과학회 1991 대한내과학회지 Vol.41 No.6

N/A To assess changes of left ventricular size and function after acute myocardial infarction, 15 patients with acute myocardial infarction were studied by 2-D echocardiogram. The left ventricular volume and extent of regional wall motion abnormality were calculated using measurements from the 2-D echocardiogram at entry and at 7 days and 2 months after acute myocardial infarction. The left ventricular volume increased from 124+40ml at entry to 143+24ml at 2 months after acute myocardial infarction in 5 patients (33.3%). The location of the infarction was the anterior wall in all of these 5 patients, who had a greater infarct area than those who had normal left ventricular volume at 2 months (p=0.07). The timing of the left ventricular dilatation after acute myocardial infarction was different in each of these 5 patients. The rest of the 10 patients (66.7%) exhibited either no change of a decrease in left ventricular volume. The wall motion score decreased from 6.2+2.9 at entry to 5.2+2.8 at 2 months (p<0.05) with no con-comitent improvement of gloval left ventricular function. No relation was demonstrated between the ejection fraction at entry and the left ventricular dilation at 2 months, Thus, left ventricular dilation after acute myocardial infarction occurs mainly in anterior wall infarction and is related to the extent of the infarct area at entry. Initial left ventricular function (ejection fraction) does not predict left ventricular dilatation 2 months after acute myocardial infarction.

관동맥 질환에서 혈청 Troponin T 의 임상적 의의

이병권(Byoung Kwon Lee),권혁문(Hyuck Moon Kwon),박현영(Hyun Young Park),박광주(Kwang Joo Park),김현승(Hyun Seung Kim),최종락(Jong Rak Choi),송경순(Kyung Soon Song) 대한내과학회 1996 대한내과학회지 Vol.50 No.1

N/A Objectives: Although the diagnosis of coronary heart disease is usually straight forward, conventional diagnostic tests, such as CK, CK-MR, LDH, and AST have several drawbacks. The diagnostic efficiency of these conventional thests is disappointingly low, especially in minimal myocardial damage. l herefore, there has be necessity of more sensitive and specific diagnostic thest. Recently, cardiac TnT (TnT) was introduced with better sensitivity, specificity, and more wide diagnostic window. So we analyzed distribution of TnT in control, release kinetics, diagnositic significance of TnT in coronary heart disease including unstable angina and acute myocardial infarction, and efficiency of TnT as a marker of reperfusion in acute myocardial infarction. Methods: We tested cardiac TnT in 40 normal healthy subjects and 25 extracardiac traumatic patients as control group. We also tested cardiac TnT in 34 patients with acute myocardial infarction and 27 patients with unstable angina. We evaluated the distribution and serial change of cardiac TnT with other cardiac enxzymes after chest pain onset, the discriminant power of Tnl in discriminating of reperfusion after thrombolytic therapy in patients with acute myocardial infarction with conventional coronary angiography and the correlation between release kinetics of TnT and left ventricular ejection fraction with echocaroliography. Results: 1) In control group, all 65 cases serum TnT value were less than 0.2㎍/L. And its specificity (100%) and sensitivity in diagnosis of coronary heart disease including untable angina(acute myocardial infarction: 100%, unstable angina 70.4%) was better than those of other cardiac enzymes, such as CK, CK-MB. 2) In patient group, the release pattern of cardiac TnT was in bimodal curve pattern, while the pattern of other cardiac enzymes was in unimodal pattern. 3) In acute myocardial infarction, the first peak value of cardiac TnT appeared siginificantly earlier (9.53±2.36 hr in stable-reperfused group, 13.40±1.92 hr in non-reperfused group of acute MI than that of caridac enzymes; CK(17.65±6.48 hr in stable-reperfused group 27.53±10.26 hr in non-reperfused group), and CK-MH (16.84±7.93hr in stable-reperfused group, 24.33±10.36 hr in non-reperfused group of acute MI)(p<0.01). And troponin T was continuously increased above the cut-off value during the test period, so the diagnostic window of TnT was longer than other cardiac enzyme. 4) In acute myocardial infarction, cardiac TnT showed better discriminant power above 80% for reperfusion than those of CK(67.65%) and CK-MB (58.82%) In stable reperfused group of acute MI, cardiac TnT showed significant correlation with left ventri- cular ejection fraction(absolute value of r >0.6, p< 0.001). Conclusion: Cardiac troponin T was a good diagnostic marker for coronary heart disease including unstable angina and acute myocardial infarction with better sensitivity and specificity, for discriminating of reperfusion after thrombolytic therapy, and for the prognosis of remnant left ventricular global systolic function

급성심근경색에서 Troponin T 와 경색의 크기와의 상관관계

서창희(Chang Hee Suh),김한수(Han Soo Kim),강한걸(Han Geol Kang),신준한(Joon Han Shin),탁승제(Seung Jae Tahk),이승호(Seong Ho Lee),최병일(Byung Il William Choi) 대한내과학회 1997 대한내과학회지 Vol.52 No.1

N/A Objectives: The estimation of infarct size has been important in evaluation of prognosis of the patients who had acute myocardial infarction. The infarct size estimated by the thallium-201 SPECT has been known to correlate with the prognosis of patient. The enzymatic estimation by the total release of creatine kinase isoenzyme MB(CK-MB) has been widely used in estimating infarct size clinically, but inconvienent and not cardiospecific. Recently, serum troponin T, cardiospecific myofibrillar protein, has been used in the diagnosis of acute myocardial infarction, and used in the estimation of reperfusion following myocardial infarction. To assess the role of the late troponin T peak concentration on the estimation of infarct size, this prospective study was carried out. Methods: The patients with acute myocardial infarction who were admitted, within 48hours after the onset of chest pain, to Ajou University Hospital between April 1995 and August 1995 were evaluated. All patients were divided into anterior and inferior infarct and checked serum troponin T and CK-MB serially, and underwent stress Thallium-201 SPECT 1 week after infarction, In each group, we assessed the correlation of the late toponin T peak concentration, the total release of CK-MB, and the infarct size estimated by thallium-201 single photon emission computed tomography(SPECT). Results: 1) The eligible subjects consisted of 22 patients (17 men and 5 women), and age ranged from 29 to 77 years(mean 57.8±12.5 years). 2) The mean arrival time to the hospital after the onset of chest pain was 15.5±13.2 hours. The 19 patients had at least one risk factor for coronaryartery disease. 3) The late troponin T peak concentration and the total release of CK-MB in patients with anterior infarction were not different from those with inferior infarction. The infarct size estimated by the thallium-201 SPECT in patients with anterior infarction was larger than patients with inferior infarction The left ventricular ejection fraction in anterio infarction was lower than inferior infarction. 4) The late troponin T peak concentration ha: positive correlation with the infarct size estimated by the thallium-201 SPECT in the total patients, and both patients with anterior infarction and inferio infarction. 5) The total release of CK-MB correlated with the infarct size estimated by the thallium-20 SPECT in the total patients, and the patients of inferior infarction. Conclusion: The late troponin T peak concentration was more accurate than the total release o CK-MB in the estimation of infarct size. Therefore, when the patient arrived to the hospital less than 48hr after the onset of chest pain, the late troponin T peak concentration is useful in the decision and evaluation of therapeutic intervention and in the prediction of prognosis.

급성심근경색증 환자에서 발생초기의 지단백질 변화

이혜진,신길자,조홍근,박시훈 梨花女子大學校 醫科大學 醫科學硏究所 2000 EMJ (Ewha medical journal) Vol.23 No.3

연구배경 : 저자등은 한국인 급성심근경색증 환자에서 첫째, 급성 흉통이후 발병초기에서 지질치의 변화를 관찰하고 둘째, 기존의 고지혈증 유무와 성별등이 지질 변동치에 영향을 주는지를 규명하며 셋째, 급성흉통 이후의 어느 시기에 측정하는 것이 기저지질치와 가장 유사하여 치료의 기준으로 삼을 수 있는가를 알아보기 위하여 본 연구를 시행하였다. 방법 : 급성흉통으로 응급실을 내원한 환자중, 28명의급성 심근경색증 환자를 대상으로 응급실 내원당시와 입원 다음날 공복시 총콜레스테롤, 저밀도 콜레스테롤, 고밀도 콜레스테롤, 중성지방을 측정하여 다음과 같은 결과를 얻었다. 결과 : 1) 급성심근경색증 환자에서 총콜레스테롤, 저밀도 콜레스테롤은 의의있는 감소를 보였다. 2) 지질변동치는 응급실 내원당시 지질수치와 양의 상관관계를 보였다. 3) 남성군에서 여성군에 비해 저밀도 콜레스테롤의 더 큰 감소폭을 보였다. 결론 : 급성심근경색증으로 응급실을 내원한 환자에서 입원 다음날 측정한 콜레스테롤치는 응급실 내원당시에 비해 의의있게 감소된 수치를 보였다. 이는 내원 다음날 측정한 지질치가 고지혈증의 진단과 치료 시작에 잘못된 판단기준으로 작용할 수 있다는 점을 시사한다. 결론적으로 급성흉통으로 응급실을 내원하는 환자에서 초기 지질측정이 필수적이며, 초기에 검사가 이루어지지 못한 경우는 지질치가 기저치에 비해 낮게 측정됐음을 고려하여 고지혈증의 치료여부를 결정해야 할 것이다. 본 논문에서는 급성흉통으로 응급실을 내원한 급성 심근경색증 환자에서 내원 당시의 수치와 비교해 볼 때 내원 다음날의 총콜레스테롤은 11.5%, 저밀도 콜레스테롤은 9.5% 감소하였다. Objectives : Hyperlipidemia is an important risk factor of coronary atherosclerosis. Serum lipids, especially cholesterol level is closely related to coronary artery and early identification and treatment of hypercholesterolemia reduced the risk of ischemic heart disease. In secondary prevention studies, lipid regulation has been demonstrated to result in a reduced incidence of myocardial infarction and mortality. But during the acute phase of a myocardial infarction, the serum lipid pattern is known to be rapidly changed and consequently dose not reflect the baseline level of the patient. Total serum cholesterol concentrations measured within 24 hours after acute myocardial infarction are likely to reflect basal levels, thus they must be used as the reference for the diagnosis and treatment of hyperlipidemia. If serum lipid levels were not measured within 24 hours of acute chest pain, it is essential to correct the lipid level to the baseline level. So we investigated the following. First, serum lipid alteration during the acute phase of acute myocardial infarction, second, the factors that are related to lipid change, third, the time to check the baseline value of lipid level during the acute phase of myocardial infarction. Methods : We have measured the total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride at admission time and the next day in a group of 51 acute myocardial infarction patients who had acute chest pain. Results : First, total cholesterol, LDL cholesterol at the next day were significantly reduced. Second, positive correlation was noted between lipid alteration and the lipid level that was checked at admission time. Last, male groups had more significant reduction of LDL cholesterol than female groups. Conclusion : Cholesterol levels thats were checked the next day were significantly reduced in comparison with the cholesterol value registered at hopital admission. Consequently, it is essential to check the lipid level at the time of hospital admission. But if it was not done, corrected values are a useful guide to patients basal lipid state and treatment references.

급성 하벽 심근경색증의 임상양상을 보인 복부 대동맥류 파열 1예

이준엽,남지형,김승민,김준섭,김강,성낙일,박정배,천우정,배준호,나득영 동국대학교 의학연구소 2006 東國醫學 Vol.13 No.2

대부분의 복부 대동맥류 파열은 저혈압, 복통을 동반하거나, 복부의 박동성 종괴가 촉지된다. 하지만 급성 심근경색의 임상양상을 나타낸 증례는 세계적으로 1예만이 보고되어 드문 것으로 알려져 있다. 그러나 수술적 치료가 요구되는 복부 대동맥류 파열과 혈전 용해제, 관상동맥성형술 등의 내과적 치료가 우선시 되는 급성 심근경색은 질환의 특성상 증상발현과 동시에 치명적인 결과를 초래할 수 있어, 신속하고 정확한 진단과 동시에 적절한 치료가 요구된다. 특히 복부 대동맥류를 가진 환자 중 22%에서 심혈관질환을 동반한 경우가 있고, 복부 대동맥류 파열로 인한 저혈압은 관상동맥의 혈류량을 감소시켜 급성 심근경색의 임상양상을 나타낼 수 있다. 따라서 급성 심근경색의 전형적인 흉통을 호소하는 환자도 이전의 병력이 없더라도 급성 대동맥 증후군의 위험인자를 가지고 있을 경우 급성 대동맥 증후군을 염두에 두어, 좀 더 세심한 이학적 검사, 전산화단층촬영 등의 대동맥에 대한 검사를 고려 해야 한다. 이에 저자들은 전형적인 급성 하벽 경색의 증상과 심전도 소견을 나타내었으나, 대동맥 조영술과 복부전산화단층촬영을 통해 복부 대동맥류 파열을 진단하였던 예를 문헌고찰과 함께 보고하는 바이다. The majority of acute aortic aneurysmal rupture presents the symptoms of hypotension, abdominal pain, and/or palpable pulsating abdominal mass. Acute aortic aneurysmal rupture with symptoms of acute myocardial infarction was rarely reported. The treatment of ruptured abdominal aortic aneurysm needs surgery, but acute myocardial infarction needs thrombolytc agents and/or coronary interventions. Hence these diseases need prompt and accurate differential diagnosis. Especially, the 22% of patients with aortic aneurysm have coronary heart disease, and the hypotension due to aortic aneurysmal rupture decreases the flow of coronary artery and causes mimic symptoms of acute myocardial infarction. Therefore, the patients with typical symptoms of acute myocardial infarction without pervious history of aortic aneurysm need more careful examination such as chest/abdominal CT for differential diagnosis of aortic aneurysmal rupture. We reported a 74-year-old female developed typical symptoms of acute myocardial infarction, but was diagnosed as ruptured abdominal aortic aneurysm by aortogram and computed tomography.

급성 심근경색 환자에서 예후 예측인자로 혈청 감마-글루타밀 트랜스퍼라제가 유용한가?

이장훈 ( Jang Hoon Lee ),채성철 ( Shung Chull Chae ),이현상 ( Hyun Sang Lee ),박용휘 ( Yong Whi Park ),류현민 ( Hyeon Min Ryu ),이순학 ( Soon Hak Lee ),배명환 ( Myung Hwan Bae ),양동헌 ( Dong Heon Yang ),박헌식 ( Hun Sik Park ) 대한내과학회 2007 대한내과학회지 Vol.72 No.3

목적: 혈청 감마-글루타밀 트랜스퍼라제(GGT)는 관상동맥 죽상경화반 내의 저밀도 지단백(LDL)의 산화과정을 촉매 하여 관상동맥 질환의 진행에 관여하며, 관상동맥 질환의 과거력이 있는 환자에서 심장사와 재경색의 독립적인 예후 예측인자로 알려져 있다. 저자는 관상동맥 질환의 과거력이 없는 급성 관상동맥 증후군 환자에서 예후 예측인자로서의 혈청 GGT의 효용성을 연구하였다. 방법: 흉통을 주소로 응급실을 방문하여 급성 심근경색으로 진단받은 환자의 혈청 GGT 값을 측정하여 응급실 방문당시 혈청 GGT 값이 정상범위(남자: 8-61 U/L; 여자: 5-31 U/L)에 있었던 192명(남/여=143/49, 평균 연령: 60.8±11.8세)의 환자를 대상으로 하여, 추적기간(16.5±10.8개월) 내 심장사건이 재발한 환자에서의 혈청 GGT 값을 심장사건이 없었던 환자의 혈청 GGT 값과 비교 하였다. 결과: 급성 심근경색 환자 192명중 추적 기간 내 17명의 환자에서 심장사와 재경색이 있었으며, 23명의 환자에서 불안정협심증이 있었다. 이 환자들의 혈청 GGT 값을 심장사건이 없었던 환자의 혈청 GGT 값과 비교하였을 때 통계적으로 유의한 차이를 보였다(29.5±10.0 U/L 대 25.0±11.2 U/L p=0.024). 그러나 다변량 분석에서 혈청 GGT에 영향을 줄 수 있는 혼란변수들과 알려진 심혈관계 질환의 위험인자로 보정하였을 경우 독립적인 예후 예측인자가 되지 못했다. 결론: 심질환의 과거력이 없는 심근경색 환자의 예후 예측인자로 심근경색의 급성기에 측정한 혈청 GGT 값은 통계적으로 유의한 차이는 있으나, 독립적인 예후 예측인자가 되지 못했다. Background: Serum gamma-glutamyl transferase activity (GGT) is able to catalyse low-density lipoprotein oxidation in coronary atherosclerotic plaques and has a role in the pathogenesis of atherosclerosis. GGT has been shown to be an independent risk factor for cardiac mortality in patients with a previous myocardial infarction. The purpose of this study is to determine the prognostic value of GGT within its normal range at an acute stage in patients with acute myocardial infarction. Methods: In a retrospective study, GGT and other cardiac risk factors were evaluated in 192 patients (M/F=143/49; mean age: 60.8±11.8 years) who were diagnosed with an acute myocardial infarction at the emergency room. We compared the serum GGT values for each patient with or without a cardiac event, including cardiac death, non-fetal myocardial infarction and unstable angina, after an acute myocardial infarction for a mean follow-up of 16.5±10.8 months. Results: During the follow-up period, 17 patients underwent cardiac death and experienced an acute myocardial infarction and 23 patients had unstable angina. Although the mean GGT values were significantly different from patients with cardiac events (29.5±10.0 U/L vs 25.0±11.2 U/L, p=0.024), serum GGT was not an independent cardiac risk factor for a cardiac event based on multivariate analysis adjusted for age, sex, alcohol and known cardiovascular risk factors. Conclusions: Serum GGT within its normal range at an acute stage in patients that experienced an acute myocardial infarction is not an independent prognostic marker. (Korean J Med 72:281-289, 2007)

급성 심근경색증에서 심근경색증 발생 직전에 발병한 협심증으로 유도된 허혈전조치 효과에 관한 연구

유규형,이영,김철홍 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.10

Are patients with angiographically near-normal coronary arteries who present as acute myocardial infarction actually safe?

other Korea Acute Myocardial Infarction Registry Investigators,Kang, W.Y.,Jeong, M.H.,Ahn, Y.K.,Kim, J.H.,Chae, S.C.,Kim, Y.J.,Hur, S.H.,Seong, I.W.,Hong, T.J.,Choi, D.H.,Cho, M.C.,Kim, C.J.,Seung, K. Elsevier/North-Holland Biomedical Press 2011 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.146 No.2

Background: There is a paucity of data concerning the clinical outcome of patients presenting with acute myocardial infarction (AMI) and near-normal coronary angiograms. The purpose of this study was to evaluate the clinical outcome and the prognosis of the patients with near-normal coronary angiograms who were registered in the Korean Acute Myocardial Infarction Registry (KAMIR). Methods: The subjects were divided into three groups according to findings from coronary angiograms performed between September 2005 and November 2006. Among 8510 consecutive AMI patients, 372 patients (Group I) had near-normal coronary arteries, 6136 patients (Group II) had one- or two-vessel disease, and 2002 patients (Group III) had three-vessel or left main disease. Results: Clinical characteristics, in-hospital mortality, and major cardiac adverse events (MACE) were analyzed. Group I was younger, had the lower prevalence of DM, and showed the higher percentage of previous angina history compared to the other two groups. Group III showed a higher incidence of in-hospital mortality, but there was no significant difference between Group I and Group II (2.6% in Group II and 2.2% in Group I, p=0.952). Furthermore, MACE at 1month, 6months and 12months revealed no significant difference between Groups I and II (12month MACE: 7.8% in Group I and 12.2% in Group II, p=0.359). Conclusions: Patients with near-normal coronary angiograms had similar clinical outcomes and prognosis compared with one- or two-vessel diseased patients presenting with an acute myocardial infarction.

당뇨병 환자에서 급성 심근경색증의 관상동맥 중재술시 혈당이 No-reflow현상에 미치는 영향

홍택종 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24

Background : Diabetes mellitus is associated with endothelial dysfunction and platelet activation that may contribute to the occurrence of coronary no-reflew, But the precise mechanism of coronary no-reflow in diabetes is not well known until now. Even more there are many debates in its role of acute and chronic hyperglycemia. It was evaluated whether hyperglycemia at admission might or not be associated with the occurrence of coronary no-reflow in diabetic patients undergoing coronary angioplasty for acute myocardial infarction. Subjects and Methods: Of the 475 acute myocardial infarction patients who had underwent coronary angioplasty between February 2003 to June 2005, angiographic and clinical characteristics were investigated in 117 diabetic patients to know the impact of hyperglycemia on the occurrence of coronary no-reflew in diabetic patients with acute myocardial infarction. Results : Of the 117 diabetic patients, 22 patients(19.5%) showed coronary no-reflow. Glucose level on admission was not different regardless of reflow disturbance(199.4 ± 88.8 vs. 212.7 ± 88.9, p = 0.568). But glycosylated hemoglobin (HbA1c) suggesting chronic hyperglycemia is higher in diabetic patients with no-reflow than in those with normal flow(7.8 ± 1.5 vs. 7.0 ± 1.2, p = 0.05). Conclusion : Intensive glucose control may improve coronary flow disturbance in diabetic patients with acute myocardial infarction undergoing coronary angioplasty. 배경 및 목적 당뇨환자는 미세혈관의 기능 장애와 혈소판의 활성으로 인해 관상동맥 혈류가 감소될 수 있는데, 그 기전은 아직 정확히 알려져 있지 않다. 더구나 급성 및 만성 고혈당이 관상동맥 no-reflow 발생에 미치는 역할에 대해 이론이 아직도 많은 실정이다. 본 연구에서는 당뇨병을 동반한 급성 심근경색증 환자에서 스텐트를 이용한 관상동맥 중재술시 행시 급성 또는 만성 고혈당이 no-reflow 현상의 발생에 미치는 영향을 알아보고자 하였다. 대상 및 방법 2003년 2월 부터 2005년 6월까지 급성 심근경색증으로 부산대학교 병원을 방문하여 관상동맥 중재술을 시행 받은 475명의 환자 중 당뇨병으로 진단받은 117명 (24.6%) 의 의무기록을 바탕으로 입원 중 시행한 당화혈색소 및 시술 전 혈당 그리고 관상동맥조영술 소견을 후향적으로 분석하였다. 결과 117명의 대상 환자 중 80.5 %인 95명에서 정상적인 혈류가 관찰되었으며 (normal flow 군) 19.5 % 인 22명에서 no-reflow 현상이 관찰되었다(no-reflow 군). 내원 당시 혈당치 (199.4±88.8 vs 212.7±88.9, p = 0.568) 는 양군 사이에 통계학적인 유의성은 없었으나 당화혈색소(7. 0 ±1.5 vs 7.8±1.2, p = 0.05)는 normal flow 군에서 no-reflow 군에 비해 낮았다. 당뇨조절은 no-reflow 군에서 인슐린 치료를 필요로 하는 빈도가 normal flow 군에 비해 높은 경향을 보였다(33. 3 % vs 14.7% p = 0.058). 결론 당뇨환자에서 적절한 혈당조절은 급성심근경색으로 인한 관상동맥 중재시술시 관상 동맥 혈류장애를 개선시킬 수 있을 것이다.

급성 심근 경색 환자에서 좌심실 기능 , 좌심방 기능 및 폐정맥 혈류 양상의 변화

김복근(Bok Kun Kim),주승재(Seung Jae Joo),배영환(Young Hwan Bae),박선미(Sun Mi Park),최진(Jin Choi),최휘(Hwi Choi),윤병철(Byung Chul Yoon),오원섭(Won Sub Oh),구양훈(Yang Hwun Koo),홍성준(Sung Jun Hong),김진(Jin Kim),박능화(Neung Hwa 대한내과학회 1997 대한내과학회지 Vol.53 No.6

N/A Objectives: Acute myocardial infarction decreases left ventricular systolic and diastolic function. Left ventricular diastolic function is usually assessed with the left ventricular filling patterns. Abnormal left ventricular tilling patterns after acute myocardial infarction can be classified as relaxation abnormality, pseudonormalization, and restriction, but sometimes the differentiation between pseudonormalization and the normal pattern is difficult. To assess left ventricular systolic and diastolic function, and left atrial function after acute myocardial infarction, M-mode, two-dimensional, pulsed Doppler, and automated border detection echocardiography were performed. To complement the information obtainable from the mitral flow patterns, pulmonary venous flow patterns were also analysed to assess the left ventricular filling patterns. Methods: Twenty six patients (mean age 60 ±10) underwent echocardiographic examination 7 to 14 days after acute myocardial infarction. Twenty healthy persons(mean age 57±12) were served as a control group. Various indexes were obtained with M-mode, two-dimensional, pulsed Doppler, and automated border detection echocardiography Results: 1) Mean age, sex ratio, heart rate, body mass index were not different between patient and control groups. There were five patients with hypertension in patient group. Left ventricular mass index of patient group was greater than that of control group (163±43g/㎡ vs. 109±22g/㎡, P<0.0D1). 2) Patients had decreased cardiac index(2.35±0.53L/min/㎡ vs. 3.02±0.70L/min/㎡, P<0.05) and left ventricular ejection fraction(55±12% vs. 62± 0.4%). There was a negative correlation between left ventricular regional wall motion score and ejection fraction(r=-0.71; P<0.001). 3) In patients, peak mitral flow velocity at atrial contraction(A) was higher(73±11cm/sec vs. 63±13 cm/sec; P<0.01), E/A ratio was lower(0.77±0.28 vs. 1.01±0.25; P<0.01), and left ventricular isovolumic relaxation time was longer(126±34msec vs. 97±21msec; P<0.005). 4) Patients had smaller systolic time-velocity integral(13.0±3.30cm vs. 14.8±2.83cm, P=0.056) and diastolic time--velocity integral(9.18±2.21cm vs. 11.2±2.77cm, P<0.01). 5) Relaxation abnormality of left ventricular filling patterns, which was classified by E/A ratio of less than 1, was more frequently founded in patients than in controls(45%). Four patients had E/A ratio of greater than 1; SV/DV ratio was greater than 1 in two and less than 1 in others. 6) End-diastolic area of left atrium(minimal area) was larger in patients(11±1.9㎠ vs. 9.6+1.4㎠, P<0.01). Therefore, patients showed decreased atrial emptying index and expansion index. Patients had a greater extent of left atrial area decrease resulting from atrial contraction. Conclusion: Patients with acute myocardial infarction showed a decreased left ventricular systolic function and a relaxation abnormality 7 to 14 days after attack, Minimal area of left atrium increased and left atrial function decreased.