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Serial echocardiographic assessment of the left ventricular function after direct PCI
Libor Nechvatal1, Ota Hlinomaz, Ladislav Groch
1Department of Cardiology, St. Anna University Hospital, Brno, Czech Republic.
Insights
Percutaneous coronary interventions (PCI) improve left ventricular (LV) function after acute myocardial infarction (AMI) within one month. However, LV remodelling occurs by one year despite restored artery patency, indicating long-term monitoring is crucial.
Area of Science:
- Cardiology
- Cardiovascular Research
- Medical Imaging
Background:
- Acute myocardial infarction (AMI) triggers left ventricular (LV) remodelling.
- Restoring infarct-related artery patency via percutaneous coronary interventions (PCI) may mitigate cardiac remodelling.
Purpose of the Study:
- To evaluate LV contractility and function using serial echocardiographic assessments post-PCI in AMI patients.
Main Methods:
- Sixty-one patients with acute MI treated with direct PCI underwent echocardiography.
- Serial echocardiograms were performed 6-8 days, 1 month, 6 months, and 12 months after PCI.
Main Results:
- LV ejection fraction and wall motion score index improved significantly by one month post-PCI.
- LV end-diastolic and end-systolic diameters remained stable at one month but increased significantly by one year.
- No further significant improvements in LV function or dimensions were observed beyond the one-month mark.
Conclusions:
- PCI-induced infarct-related artery patency demonstrates beneficial effects on LV remodelling in the short term after AMI.
- Long-term LV dimensions increase by one year, suggesting ongoing remodelling despite initial functional improvements.
Background:
Acute myocardial infarction (AMI) causes remodelling of the left ventricle (LV). Restoration of patency of an infarct-related artery by percutaneous coronary interventions (PCI) may prevent or inhibit cardiac remodelling.
Aim:
To assess LV contractility and function by serial echocardiographic examinations.
Methods:
The study group consisted of 61 patients (47 males, mean age 60+/-10 years) with acute MI treated with direct PCI. Echocardiography was performed 6-8 days after PCI, and 1, 6 and 12 months thereafter.
Results:
LV ejection fraction increased significantly at the end of the first month in comparison with the baseline examination whereas EF values obtained after 6 months and after 1 year were not significantly different. Wall motion score index showed a significant improvement after one month, whereas it did not show any further improvement when measured after 6 or 12 months after AMI. The baseline LV end-diastolic diameter was 49+/-6 mm and did not change after one or 6 months, whereas it increased significantly 12 months after AMI. The baseline LV end-systolic diameter was 37+/-5 mm. At the one-month and six-month examinations it was similar to the baseline values but increased significantly to 38+/-6 mm after one year.
Conclusions:
These results confirm the beneficial effects of PCI-induced infarct-related artery patency on LV remodelling after AMI.