Batra Mahesh Kumar, Malik Muhammad Atif, Khan Kamran Ahmed, Rai Lajpat, Kumar Rajesh, Shah Jehangir Ali, Sial Jawaid Akbar, Saghir Tahir, Khan Naveedullah, Karim Musa
Department of Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Department of Cardiology, Al Mana General Hospital, Eastern Region, Hofuf, Saudi Arabia.
J Cardiovasc Echogr. 2022 Jan-Mar;32(1):12-16. doi: 10.4103/jcecho.jcecho_64_21. Epub 2022 Apr 20.
Improvement in left ventricular (LV) function after revascularization is an important determinant of long-term prognosis in a patient with acute myocardial infarction (AMI). However, data on the changes of LV function after revascularization are scarce in our population. Hence, this study was conducted to evaluate the changes in LV function and dimensions by echocardiography at 3 and 6 months after primary percutaneous coronary intervention (PCI).
A total of 188 patients were recruited in this study who had undergone primary PCI. Patients with preexistent LV dysfunction, prior PCI, or with congenital heart disease were excluded. Echocardiography was performed at baseline (within 24 h of intervention), 3 months, and 6 months of intervention. Remodeling in terms of change in LV ejection fraction (LVEF), LV end-diastolic dimension (LVEDD), LV end-systolic dimension, and wall motion score index (WMSI) was evaluated.
Out of the 188 patients, 90.4% were male, and mean age was 53.94 ± 9.12 years. Baseline mean LVEF was 39.79 ± 6.2% with mean improvement of 5.11 ± 3.87 ( < 0.001) at 3 months and 6.38 ± 4.29 ( < 0.001) at 6 months. Baseline LVEDD was 46.23 ± 3.86 mm which improved to 44.68 ± 2.81 mm at 6 months. Basal WMSI decreased by -0.09 ± 0.08 and -0.13 ± 0.09 at 3 and 6 months, respectively, after revascularization.
Primary PCI is the recommended mode of reperfusion in patients with AMI. It reduces infarct size, maintains microvascular integrity and preserves LV systolic function hence improving LV function.
血运重建术后左心室（LV）功能的改善是急性心肌梗死（AMI）患者长期预后的重要决定因素。然而，在我们的人群中，关于血运重建术后LV功能变化的数据很少。因此，本研究旨在通过超声心动图评估直接经皮冠状动脉介入治疗（PCI）后3个月和6个月时LV功能和尺寸的变化。
本研究共纳入188例行直接PCI的患者。排除既往有LV功能障碍、既往PCI或先天性心脏病的患者。在基线（介入后24小时内）、介入后3个月和6个月进行超声心动图检查。评估LV射血分数（LVEF）、LV舒张末期内径（LVEDD）、LV收缩末期内径和壁运动评分指数（WMSI）变化方面的重塑情况。
188例患者中，90.4%为男性，平均年龄为53.94±9.12岁。基线时平均LVEF为39.79±6.2%，3个月时平均改善5.11±3.87（P<0.001），6个月时平均改善6.38±4.29（P<0.001）。基线LVEDD为46.23±3.86mm，6个月时改善至44.68±2.81mm。血运重建后3个月和6个月时，基底WMSI分别下降-0.09±0.08和-0.13±0.09。
直接PCI是AMI患者推荐的再灌注方式。它可缩小梗死面积，维持微血管完整性并保留LV收缩功能，从而改善LV功能。
