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Left ventricular remodeling assessment in patients with anterior acute myocardial infarction treated with successful primary percutaneous coronary intervention: an observational study [Anatol J Cardiol]
Anatol J Cardiol. 2013; 13(7): 675-681 | DOI: 10.5152/akd.2013.192

Left ventricular remodeling assessment in patients with anterior acute myocardial infarction treated with successful primary percutaneous coronary intervention: an observational study

Hatice Uslu1, Nazmiye Çakmak2, Melih Engin Erkan3, Sevim Hacımahmutoğlu2, Sabire Yılmaz4, Sevil Özkan2, Nurten Sayar5
1Department of Nuclear Medicine, Faculty of Medicine, İstanbul Medeniyet University, İstanbul-Turkey
2Clinic of Cardiology, Siyami Ersek Cardio-Vascular Surgery Hospital, İstanbul-Turkey
3Department of Nuclear Medicine, Faculty of Medicine, Düzce University, Düzce-Turkey
4Department of Nuclear Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul-Turkey
51Clinic of Cardiology, Siyami Ersek Cardio-Vascular Surgery Hospital, İstanbul-Turkey

Objective: We aimed to analyze the left ventricular (LV) remodeling in patients treated with coronary intervention (PCI) in the acute phase of anterior myocardial infarction (MI) and to analyze the relationship between LV functional remodeling and residual viability in the infarct zone detected by thallium-201 (Tl-201) imaging and echocardiography. Methods: We designed an observational prospective cohort study including 30 patients (26 men, 4 women, mean age; 52±12 years old) with acute anterior MI. Echocardiography and Tl-201 imaging were performed in all patients three days and two months after PCI and left ventricular end-systolic volume (ESV), left ventricular end-diastolic volume (EDV), ejection fraction (EF) and sum redistribution score (SRS) were calculated. Paired samples t- test or Wilcoxon rank sign test for comparing continuous variables in dependent groups, Pearson correlation for testing relationship between continuous variables were used. Results: Left ventricular function baseline values just after PCI and two months after PCI obtained by echocardiography and scintigraphy were statistically significant. Among patients 76.7% had an EF ≥0.50 after the event. EDV and ESV values are significantly low when compared to values two months before. There was not any marked change in SRS in five patients. Polar maps were correlated with heart rate (r=0.438; p=0.023), peak creatine kinase MB (r=0.440; p=0.015) and troponin (r=0.471; p=0.009) during acute MI. Conclusion: Significant recovery in EDV, ESV and SRS values, and increase in EF two months after the infarction shows us substantial part of the remodeling process is completed in two months and Tl-201 imaging is extremely effective in determining of salvaged myocardium.

Keywords: determining of salvaged myocardium.(Anadolu Kardiyol Derg 2013; 13(0): 000-000)Key words:

Hatice Uslu, Nazmiye Çakmak, Melih Engin Erkan, Sevim Hacımahmutoğlu, Sabire Yılmaz, Sevil Özkan, Nurten Sayar. Left ventricular remodeling assessment in patients with anterior acute myocardial infarction treated with successful primary percutaneous coronary intervention: an observational study. Anatol J Cardiol. 2013; 13(7): 675-681