Comparison of the left ventricular electromechanical map before percutaneous coronary stent revascularization and at...

The study aimed to evaluate the safety and potential of percutaneous transluminal electromechanical mapping (NOGA) in patients with regional myocardial wall dysfunction after a recent ST elevation myocardial infarction (STEMI). Regional myocardial wall dysfunction is a major cause of morbidity in survivors of ST elevation myocardial infarction. Fifteen males who recently had suffered a STEMI were studied prospectively with coronary angiography, ventriculography, and NOGA before and 1 month after percutaneous coronary intervention (PCI). The left ventricular angiographic ejection fraction increased from 50% +/- 11% before PCI to 56% +/- 10% at follow-up (P = 0.006). Qualitative analysis of the NOGA color map identified and outlined an area of regional wall dysfunction in all patients. Quantitative analysis of the NOGA maps showed improvements at follow-up after PCI in regional wall parameters of the infarct area (bipolar voltage: 1.7 +/- 1.4 mV before intervention, 2.2 +/- 1.6 mV at follow-up, P = 0.05; local shortening, a NOGA parameter on wall motion: 3.5% +/- 6.2% before, 7.4% +/- 5.8% at follow-up, P = 0.01), whereas there were no changes in the noninfarcted area (bipolar voltage: 2.7 +/- 2.5 mV before intervention, 2.8 +/- 2.6 mV at follow-up, P = 0.99; local shortening: 7.8% +/- 7.8% before, 8.2% +/- 7.8% at follow-up, P = 0.99). There were no complications to the NOGA procedures. In patients treated with PCI for a recent STEMI, NOGA might be considered used in the quantification of myocardial recovery and in the outlining of myocardial areas of incomplete or no recovery.