Prevalence and predictors of left ventricle regional wall motion abnormality (RWMA) six weeks after primary percutaneous intervention (PPCI) in patients with first acute anterior myocardial infarction (MI)
- سال انتشار: 1397
- محل انتشار: دومین کنگره بین المللی سندرم های کرونری حاد ایران
- کد COI اختصاصی: ICACSMED02_078
- زبان مقاله: انگلیسی
- تعداد مشاهده: 503
نویسندگان
Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
چکیده
Introduction: Regional wall moion abnormality (RWMA) occurs after acute myocardial infarction(MI) ,and this may take place in the area of primary percutaneous coronary intervention(PPCI).The predicting factors of RWMA after primary PCI still need to be clarified. The aim of the study was to assess the prevalence and to define the baseline clinical, angiographic and echocardiographic predictors of RWMA after PPCI in patients with acute anterior MI.Materials and methods: Of the 110 patients initially selected for the study 107(85men and 22women, mean age 58.21±11.64 years) with first anterior MI treated with primary PCI were evaluated. Transthoracic echocardiographic examination was performed at admission time and after 6weeks.The RWMAwas assessed and WMSI was calculated by dividing sum of the wall motion score over the number of visualized segments.Results : Ninety-one patients (85%) had a positive RWMA. The mean time of the symptom-onset to balloon and door to balloon were 307.27±275.26 and 68.96±81.97 minutes, respectively. It was revealed no statistically significant association between symptom-onset to balloon time and door to balloon time compared with WMSI value (p=0.29, r: 0.105) (p=0.53, r: -0.062). For post-PPCI TIMI flow grades, the patients with a grade II and III TIMI flow had a mean WMSI value of 1.90±0.39and 1.65±0.31, respectively, that was significantly higher in patients with a grade II TIMI flow (p= 0.002) .Duringfollow-up echocardiography, 84 (79.2%) patients had a positive RWMA. Follow-up positive RWMA was significantly lower (7.4%) in patients suffered from stable angina (p= 0.01). Statistically noticeable improvements in the level of WMSI and E/E’ ratio during the follow up period of echocardiographywas reported. Also there was significant relation between pre and post-PCI LVESV and WMSI compared with post-PCI RWMA (p=0.03,p< 0.0001), (p=0.007 , p< 0.0001). However, no statistically significant differences were observed in the demographic data and MI risk factors considering the incidence of RWMA and the mean value of WMSI.Conclusion: In patients with the first acute MI, higher WMS index and LVESV level are strongly related to the RWMA incidence after six weeks which could be applied as predictor factors of RWMA incidenceکلیدواژه ها
Myocardial infarction,primary PCI, RWMA, WMSIمقالات مرتبط جدید
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