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Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
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Every minute counts: in-hospital changes of left ventricular regional and global function in patients with ST-segment

Valeria Cammalleri1, Giorgia Marsili1, Maria Stelitano1

  • 1Department of Cardiovascular Disease.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|November 2, 2020
PubMed

Insights

Early percutaneous coronary intervention improves heart function in ST-segment elevation myocardial infarction patients. Shorter first medical contact-to-reperfusion times significantly enhance left ventricular ejection fraction and wall motion recovery.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring prompt treatment.
  • Left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) are key indicators of cardiac function post-myocardial infarction.
  • The impact of reperfusion time on cardiac recovery in STEMI patients remains an area of active research.

Purpose of the Study:

  • To evaluate the effect of early percutaneous coronary intervention (PCI) on in-hospital LVEF and WMSI changes in STEMI patients.
  • To compare the cardiac functional recovery between STEMI patients treated with different first medical contact (FMC)-to-reperfusion times.
  • To identify predictors of significant LVEF improvement in STEMI patients undergoing PCI.

Main Methods:

  • A cohort of 324 STEMI patients undergoing PCI was divided into two groups based on FMC-to-reperfusion time: ≤90 minutes (n=173) and >90 minutes (n=151).
  • LVEF and WMSI were assessed at baseline and at discharge.
  • A subgroup analysis was conducted on patients with ≥10% LVEF improvement at discharge.

Main Results:

  • Baseline LVEF and WMSI were comparable between the two groups.
  • Patients with FMC-to-reperfusion time ≤90 minutes showed significant improvements in LVEF (P=0.001) and WMSI (P=0.009) at discharge.
  • Shorter FMC-to-reperfusion and total ischemic times were associated with a ≥10% LVEF improvement.

Conclusions:

  • Early PCI, defined by FMC-to-reperfusion time ≤90 minutes, significantly improves in-hospital left ventricular global and regional function in STEMI patients.
  • Reducing total ischemic time is crucial for optimal cardiac recovery and functional improvement post-STEMI.
  • These findings reinforce the importance of timely reperfusion strategies in managing STEMI.
Abstract

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