Improvements in Regional Left Ventricular Function Following Late Percutaneous Coronary Intervention for Anterior Myocardial Infarction
Clinical Medicine Insights: Cardiology
infarct-related artery patency, Myocardial infarction, percutaneous coronary intervention, revascularization
Background: Late revascularization following a myocardial infarction has questionable clinical benefit. Methods: We studied 13 patients with anterior wall myocardial infarction who underwent percutaneous coronary intervention within 2 weeks of the primary event, by quantitative analysis of 2-dimensional echocardiographic images. Endocardial segmentations of the left ventricular (LV) endocardium from the 4-chamber views were studied over time to establish cumulative wall displacements (CWDs) throughout the cardiac cycle. Results: Left ventricular end-systolic volume decreased to 42 ± 8 mL/body surface area (P =.034) and LV ejection fraction improved to 52% ± 7% (P =.04). Analysis of LV endocardial CWD demonstrated significant improvements in mid-systolic to late-systolic phases in the apical LV segments, from 3.5 ± 0.32 to 5.89 ± 0.43 mm (P =.019). Improvements in CWD were also observed in the late-diastolic phase of the cardiac cycle, from 1.50 ± 0.42 to 1.76 ± 0.52 mm (P =.04). Conclusions: In our pilot patient cohort, following late establishment of infarct-related artery patency following an anterior wall myocardial infarction, regional improvements were noted in the LV apical segments during systole and late diastole.
Adhyapak, S., Menon, P., Varghese, K., Mehra, A., Lohitashwa, S., & Fantini, F. (2017). Improvements in Regional Left Ventricular Function Following Late Percutaneous Coronary Intervention for Anterior Myocardial Infarction. Clinical Medicine Insights: Cardiology, 11. https://doi.org/10.1177/1179546817746636