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Left ventricular shape and function in primary coronary angioplasty.

Abstract：

OBJECTIVES:To evaluate the effects of primary coronary angioplasty (PCA) on regional left ventricular (LV) contractile dysfunction and deformation, and on global remodeling. METHODS:In 99 consecutive patients (81 males, aged 61+/-11 years) who underwent successful PCA of left anterior descending (LAD) and right coronary (RCA) arteries for treatment of first myocardial infarction and completed a hemodynamic follow-up at 1 and 6 months, LV eccentricity and circularity indexes, centreline wall motion and regional curvature were analyzed. Asynergy and akinesia were defined as centreline impairment -1 standard deviation) at 6 months was used to categorize the outcome as improved. RESULTS:Systolic deformation and impairment of regional LV function soon after LAD and RCA occlusion closely resembled those of the chronic myocardial infarction. PCA improved regional contractility in all patients, due to early salvage of the epicardial injured myocardium, and at least in two fifths of patients the injury area magnitude reduced by improvement of the ischemic boundaries of the infarct. Irrespective of either persistently impaired or normalized regional contractility, LV shape remained abnormal. In contract to the persistence of local deformation, global remodeling was observed in patients categorized as the highest end-diastolic volume quartile at presentation who had greater myocardial damage. CONCLUSION:Regional contractility impairment induced by acute myocardial infarction can be reverted by PCA, but systolic shape deformation persists over time.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Barletta G,Antoniucci D,Buonamici P,Toso A,Del Bene R,Fantini F

doi

10.1016/j.ijcard.2007.03.113

subject

Has Abstract

pub_date

2008-04-25 00:00:00

pages

364-75

issue

3

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(07)00651-1

journal_volume

125

pub_type

杂志文章

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