Indicators of myocardial dysfunction and quality of life, one year after acute infarction

Background: There remains controversy concerning the association between myocardial dysfunction diagnosed soon after acute myocardial infarction (AMI), and subsequent quality of life. Aims: We searched for a correlation between criteria of myocardial dysfunction assessed within the first month after AMI, and quality of life perceived 1 year later. Methods: Six hundred and seventy-one patients were followed up and quality of life was assessed using the Nottingham Health Profile. Spearman correlation was used for univariate analyses. A logistic regression identified independent predictors of impaired quality of life. Results: Patients perceiving inferior quality of life were 61% for energy, 61% for sleep, 49% for physical mobility, 49% for pain, 63% for emotional reactions, and 28% for social isolation. Impaired quality of life was not associated with the initial Killip class. A low ejection fraction was associated with impaired physical mobility (OR = 1.21, 95% CI = 1.05-1.39). Presence of abnormally contracting myocardial segments was associated with impaired mobility (1.40, 1.09-1.80) and with increased pain (1.30, 1.02-1.66). The presence of diseased coronary vessels was associated with pain (1.25, 1.06-1.46). Conclusion: Myocardial dysfunction was generally associated with impaired quality of life. This has to be considered when assessing improvement of quality of life after medical or surgical treatment of AMI.