کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5948065 1172376 2012 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Prognostic value of reverse left ventricular remodeling after primary angioplasty for STEMI
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Prognostic value of reverse left ventricular remodeling after primary angioplasty for STEMI
چکیده انگلیسی

AimsThus far, the prognostic value of reverse left ventricular (LV) remodeling after ST-elevation acute myocardial infarction (STEMI) has not been fully evaluated. We sought to investigate the incidence, major determinants, and long-term clinical significance of reverse LV remodeling in a large series of STEMI patients successfully treated with primary percutaneous coronary intervention (P-PCI).Methods and resultsSerial complete 2D-echocardiograms were obtained within 24 h after P-PCI, and at 1 and 6 months in 512 consecutive reperfused STEMI patients. Reverse remodeling was defined as a reduction >10% in LV end-systolic volume (LVESV) at 6 month follow-up. Reverse LV remodeling occurred in 49% of study population. At follow-up (41.6 ± 23 months), late heart failure (HF) rate was significantly higher among patients without reverse LV remodeling as compared with those with it (32% vs. 11%, P < 0.0001). At multivariate analysis, independent predictors of reverse LV remodeling were a small infarct size measured as peak creatine kinase value (P < 0.0001), a small functional myocardial damage measured as wall motion score index within the infarct zone (P = 0.018) and baseline LVESV (P < 0.0001). After adjustment for several clinical, echographic and angiographic variables, Cox analysis identified reverse LV remodeling as the only beneficial independent predictor of long-term heart failure-free survival (HR: 0.44, 95% CI: 0.275-0.722).ConclusionsReverse LV remodeling occurred in half of successfully reperfused STEMI patients. Small structural and functional myocardial damages within the infarct zone are the major determinants of reverse LV remodeling. As expression of effective myocardial salvage by P-PCI, the reverse remodeling is an important predictor of favorable long-term outcome.

► Reverse left ventricular remodeling after STEMI has not been fully evaluated. ► Reverse LV remodeling occurred in 49% of STEMI when primary PCI is systematically applied. ► Reverse LV remodeling is expression of effective myocardial salvage by primary PCI. ► Reverse LV remodeling is an important predictor of favorable long-term outcome.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Atherosclerosis - Volume 222, Issue 1, May 2012, Pages 123-128
نویسندگان
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