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Published on: December 2, 2014
Incidence, determinants, and prognostic value of reverse left ventricular remodelling after primary percutaneous
Stefania Funaro1, Giuseppe La Torre, Mariapina Madonna
1Department of Cardiology, Catholic University of the Sacred Heart, Campobasso, Italy.
European Heart Journal
|December 23, 2008
Summary
Reverse left ventricular remodelling (r-LVR) occurs in 39% of ST-elevation myocardial infarction (STEMI) patients treated with primary PCI. Preserved microvascular flow is key, and r-LVR predicts better long-term survival.
Area of Science:
- Cardiology
- Cardiovascular Research
- Myocardial Infarction Research
Background:
- Limited data exist on reverse left ventricular remodelling (r-LVR) post-STEMI.
- Understanding r-LVR determinants and prognostic value is crucial for STEMI management.
Purpose of the Study:
- To evaluate the incidence, determinants, and long-term significance of r-LVR in STEMI patients.
- To investigate the role of microvascular flow in promoting r-LVR.
Main Methods:
- 110 STEMI patients undergoing primary PCI had serial echocardiograms and myocardial contrast studies.
- r-LVR defined as >10% LVESV reduction at 6 months; 2-year clinical follow-up obtained.
Main Results:
- r-LVR occurred in 39% of patients.
- Independent predictors of r-LVR included effective microvascular reflow, in-hospital perfusion improvement, initial LVESV, and time to reperfusion.
- r-LVR was the sole independent predictor of 2-year event-free survival.
Conclusions:
- r-LVR is frequent in STEMI patients treated with primary PCI.
- Preserved microvascular perfusion is the main determinant of r-LVR.
- r-LVR is a significant predictor of favorable long-term outcomes.
