Key result
Primary percutaneous coronary intervention in acute anterior MI was associated with significant recovery in left ventricular volumes at two months, with 76.7% of patients achieving an EF ≥0.50.
Why the study?
Does successful primary PCI improve left ventricular remodeling and viability parameters at 2 months in patients with acute anterior myocardial infarction?
Cohort (n=30)
Does successful primary PCI improve left ventricular remodeling and viability parameters at 2 months in patients with acute anterior myocardial infarction?
Significant left ventricular remodeling and functional recovery occur within two months after successful primary PCI for anterior acute myocardial infarction, which can be effectively assessed by Tl-201 imaging and echocardiography.
May support 2-month LV monitoring after primary PCI in anterior MI; hypothesis-generating and requires randomized confirmation before practice change.
OBJECTIVE: We aimed to analyze the left ventricular (LV) remodeling in patients treated with coronary intervention (PCI) in the acute phase of anterior myocardial infarction (MI) and to analyze the relationship between LV functional remodeling and residual viability in the infarct zone detected by thallium-201 (Tl-201) imaging and echocardiography. METHODS: We designed an observational prospective cohort study including 30 patients (26 men, 4 women, mean age; 52±12 years old) with acute anterior MI. Echocardiography and Tl-201 imaging were performed in all patients three days and two months after PCI and left ventricular end-systolic volume (ESV), left ventricular end-diastolic volume (EDV), ejection fraction (EF) and summed redistribution score (SRS) were calculated. Paired samples t- test or Wilcoxon rank sign test for comparing continuous variables in dependent groups, Pearson correlation for testing relationship between continuous variables were used. RESULTS: Left ventricular function baseline values just after PCI and two months after PCI obtained by echocardiography and scintigraphy were statistically significant. Among patients 76.7% had an EF ≥0.50 after the event. EDV and ESV values are significantly low when compared to values two months before. There was not any marked change in SRS in five patients. Polar maps were correlated with heart rate (r=0.438; p=0.023), peak creatine kinase MB (r=0.440; p=0.015) and troponin (r=0.471; p=0.009) during acute MI. CONCLUSION: Significant recovery in EDV, ESV and SRS values, and increase in EF two months after the infarction shows us substantial part of the remodeling process is completed in two months and Tl-201 imaging is extremely effective in determining of salvaged myocardium.
No takes yet. Share an insight, caveat, or question.
Uslu et al. (2013) conducted a cohort in Acute anterior myocardial infarction (n=30). Primary percutaneous coronary intervention (PCI) was evaluated on Left ventricular remodeling (ESV, EDV, EF, and SRS) at two months compared to baseline. Primary percutaneous coronary intervention in acute anterior MI was associated with significant recovery in left ventricular volumes at two months, with 76.7% of patients achieving an EF ≥0.50.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: