scholarly journals Echocardiographic Evaluation of left Ventricular Function Following Late Percutaneous Coronary Intervention after Acute Anterior Myocardial Infarction with Left Ventricular Systolic Dysfunction

2018 ◽  
Vol 33 (2) ◽  
pp. 90-93
Author(s):  
Md Tufazzal Hossen ◽  
Sayed Ali Ahsan ◽  
Md Abu Salim ◽  
Khurshed Ahmed ◽  
Md Mukhlesur Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Coronary Stenting ◽  
Lv Function ◽  
P Value ◽  
Anterior Myocardial Infarction ◽  
Late Intervention ◽  
Percutaneous Coronary

Background: The effect of late percutaneous coronary intervention on left ventricular function is incompletely understood. Objectives: To evaluate the effect of late Percutaneous Coronary Intervention on LV systolic function following coronary stenting after acute anterior myocardial infarction. Methods: A total of 60 patients, > 24 hours to 6 weeks after anterior AMI who attended in UCC, BSMMU between July 2014 to June 2015 were included in this study. They underwent coronary stenting. After coronary stenting all patients were in TIMI flow-3. Serial echocardiographic assessment of LV function before and after late intervention with modified Simpson’s rule in apical 4 chamber view as well as comparison between baseline result with that of after intervention were done. The patients were on standard medical therapy in post intervention period. Result: Mean age was 54.3±8.91 years with minimum 30 years and maximum 75 years. Most of the patients were male (67%). LVESV was 60.0±14.4 ml before PCI and 58.3±15.3 ml at discharge (p value 0.091) & 44.1±17.6 ml after 3 months (p value <0.001). LVEF was 40.2±3.1% before PCI, 40.2±3.3% at discharge (p value 0.509) & 47.6±5.9% after 3 months (p value <0.001). There was no significant improvement of LV function from baseline till discharge but significant improvement occurred after 3months. Conclusion: Using echocardiographic techniques, our results showed that left ventricular volume decreased and the left ventricular ejection fraction increased significantly after three months of late intervention. Bangladesh Heart Journal 2018; 33(2) : 90-93

scholarly journals Evaluation of patients with myocardial infarction undergoing percutaneous coronary intervention (PCI) using low dose dobutamine stress echocardiography

2019 ◽  
Vol 10 (2) ◽  
pp. 1516-1522
Author(s):  
Reem Jamal Jabir ◽  
Affan Ezzat Hasan ◽  
Qasim Mohammed Jumaah ◽  
Layth Rafea Taqa
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Low Dose ◽  
Heart Diseases ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Ischemic Myocardium ◽  
Lv Function ◽  
P Value ◽  
Percutaneous Coronary

Coronary artery disease (CAD) is a spectrum of heart diseases which has the highest mortality in the world. Systolic left ventricular (LV) function is an important predictor of outcome, and its precise assessment remains of great importance for the choice of treatment in populations with myocardial infarction (MI). This study was aimed to assess the function and viability of ischemic myocardium of LV before and after the percutaneous coronary intervention (PCI) by using 2dimentional (2D) STE with LDDSE and to know the usefulness of low dose dobutamine (LDD) test in detecting the viable ischemic LV area. The results of the current study revealed there was a significant decrease (improvement) in GLS before dobutamine from (-10.49±3.4) to (-12.87±3.44) after dobutamine. Then there was a significant increase (deterioration) in GLS from (-12.87±3.44) after giving 5 mg/kg/min dobutamine to (-11.56±3.29) after giving 10 mg/kg/min dobutamine (P value < 0.001). While there were no significant differences in GLS after low dose dobutamine (-12.87±3.44) with the same parameters 3-6 months after PCI (-13.48±3.7). Left anterior descending artery (LAD) is the most common affected artery in our study. The study concluded that GLS provides a sensitive measure of LV function and appears reduced despite preserved LVEF also GLS can detect the viability of ischemic myocardium of LV with using LDD test which then assessed by PCI.

scholarly journals Improvements in Regional Left Ventricular Function Following Late Percutaneous Coronary Intervention for Anterior Myocardial Infarction

2017 ◽  
Vol 11 ◽  
pp. 117954681774663
Author(s):  
Srilakshmi M Adhyapak ◽  
Prahlad G Menon ◽  
Kiron Varghese ◽  
Abhinav Mehra ◽  
SB Lohitashwa ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Cardiac Cycle ◽  
Coronary Intervention ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Anterior Myocardial Infarction ◽  
Regional Left Ventricular Function ◽  
Percutaneous Coronary ◽  
Anterior Wall Myocardial Infarction

Background: Late revascularization following a myocardial infarction has questionable clinical benefit. Methods: We studied 13 patients with anterior wall myocardial infarction who underwent percutaneous coronary intervention within 2 weeks of the primary event, by quantitative analysis of 2-dimensional echocardiographic images. Endocardial segmentations of the left ventricular (LV) endocardium from the 4-chamber views were studied over time to establish cumulative wall displacements (CWDs) throughout the cardiac cycle. Results: Left ventricular end-systolic volume decreased to 42 ± 8 mL/body surface area ( P = .034) and LV ejection fraction improved to 52% ± 7% ( P = .04). Analysis of LV endocardial CWD demonstrated significant improvements in mid-systolic to late-systolic phases in the apical LV segments, from 3.5 ± 0.32 to 5.89 ± 0.43 mm ( P = .019). Improvements in CWD were also observed in the late-diastolic phase of the cardiac cycle, from 1.50 ± 0.42 to 1.76 ± 0.52 mm ( P = .04). Conclusions: In our pilot patient cohort, following late establishment of infarct-related artery patency following an anterior wall myocardial infarction, regional improvements were noted in the LV apical segments during systole and late diastole.

Abstract 2664: Clinical Outcome and Left Ventricular Contractile Function After Distal Protection in Primary Percutaneous Coronary Intervention The Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction (DEDICATION) Trial

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Klaus F Kofoed ◽  
Henning Kelbæk ◽  
Leif Thuesen ◽  
Steen H Poulsen ◽  
Christian Hassager ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Clinical Outcome ◽  
Wall Motion ◽  
Contractile Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Lv Function ◽  
Percutaneous Coronary ◽  
Distal Protection

Objective Embolization of material from an infarct-related lesion during percutaneous coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on clinical outcome and myocardial function. Methods and results Patients with STEMI were randomly referred within 12 hours for PCI with (n = 312) or without distal protection (n = 314). Left ventricular (LV) contractile function was assessed with echocardiography 8 month after PCI. Global LV myocardial wall motion index (WMI) was calculated as the average wall motion score of all myocardial segments. Major adverse cardiac and cerebral events (MACCE) 8 months after PCI was 7.1 % after distal protection and 5.7 % after conventional treatment (p = 0.17). WMI improved by 4.1% at 8 months in patients treated with distal protection compared to patients receiving conventional PCI (p<0.01). In myocardium subtended by culprit coronary vessels treated with distal protection regional LV function was 9 –11% higher than myocardial regions treated conventionally (p<0.02). Conclusion Routine use of distal protection during primary PCI is associated with a significant improvement in LV contractile function, with no detectable impact on intermediate term clinical outcome.

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