Recovery of left ventricular function after primary angioplasty for acute myocardial infarction.
AIMS: To study recovery of segmental wall thickening (SWT), ejection fraction (EF), and end-systolic volume (ESV) after acute myocardial infarction (AMI) in patients who underwent primary stenting with drug-eluting stents. Additionally, to evaluate the predictive value of magnetic resonance imaging (MRI)-based myocardial perfusion and delayed enhancement (DE) imaging. METHODS AND RESULTS: Twenty-two patients underwent cine-MRI, first-pass perfusion, and DE imaging 5 days after successful placement of a drug-eluting stent in the infarct-related coronary artery. Regional myocardial perfusion and the transmural extent of DE were evaluated. A per patient perfusion score was calculated and consisted of a summation of all segmental scores. Myocardial infarct size was quantified by measuring the volume of DE. At 5 months after AMI, cine-MRI was performed and SWT, EF, and ESV were quantified. EF increased from 48+/-11 to 55+/-9% (P<0.01). SWT at 5 months was inversely related to baseline segmental DE scores (P<0.001) and segmental perfusion scores (P<0.001). EF and ESV at 5 months were related to acute infarct size (R(2)=0.65; P<0.001 and R(2)=0.78; P<0.001, respectively) and the calculated perfusion score (R(2)=0.23; P=0.02 and R(2)=0.14; P=0.09, respectively) at baseline. CONCLUSION: Marked recovery of left ventricular function was observed in patients receiving a drug-eluting stent for AMI. DE imaging appears to be a better prognosticator than perfusion imaging.
|Keywords||*Stents, Analysis of Variance, Coronary Circulation/physiology, Drug Implants, Female, Humans, Magnetic Resonance Angiography/methods, Magnetic Resonance Imaging, Cine/methods, Male, Middle aged, Myocardial Infarction/drug therapy/physiopathology/*surgery, Recovery of Function, Regression Analysis, Stroke Volume/physiology, Ventricular Dysfunction, Left/physiopathology/*surgery|
|Persistent URL||dx.doi.org/10.1093/eurheartj/ehi131, hdl.handle.net/1765/13702|
|Journal||European Heart Journal|
|Note||Epub 2005 Feb 16|
Baks, T, van Geuns, R.J.M, Biagini, E, Wielopski, P, Mollet, N.R.A, Cademartiri, F, … de Feyter, P.J. (2005). Recovery of left ventricular function after primary angioplasty for acute myocardial infarction. European Heart Journal, 26(11), 1070–1077. doi:10.1093/eurheartj/ehi131