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Tytuł: Determinants and consequences of impaired reperfusion in patients with ST-segmentelevation myocardial infarction treated with primary percutaneous coronaryintervention
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Introduction: Mechanical reperfusion significantly improves the results oftreatment in patients with acute ST-segment elevation myocardialinfarction(STEMI). Its effectiveness is limited by the occurrence ofmicrovascular damage, known as impaired reperfusion (no-reflowphenomenon).Objective: To find factors independently associated with the occurrence ofimpaired reperfusion, and to determine the prognostic value of the no-reflowphenomenon for left ventricula(LV) remodeling and function recovery inpatients with STEMI treated with primary percutaneous coronaryintervention(PCI).Methods: Data of 108 patients with STEMI were studied. Myocardial perfusionwas assessed using angiography and ecg. The enzymatic injury was evaluatedaccording to CK,CK-MB, TnI level. The LV function and remodeling wasexamined by echocardiography and magnetic resonance imaging(MRI) atbaseline and then after 4 months. The microvascular obstruction (MVO) areawas measured by MRIResults: The multivariate analysis showed that left anterior descending arterywas independently associated with the lack of restoration of full epicardialflow(TIMI<3) or incomplete tissue reperfusion (TMPG-0/1) after PCI (p=0,049p=0,035). The strongest determinant of MVO was infarct size (p<0,0001). TheLV remodeling expressed as a 20% increase of the end-diastolic volume index(EDVI) within 4 m. after STEMI was determined by baseline EDVI ( ; p<0,0001),infarct size (p=0,015) and MVO (p=0,043). 20% increase of the end-systolicvolume index(ESVI) was associated with enzymatic damage (p=0,007)Conclusions: The size of ischemic territory is the strongest predictor of theoccurrence and severity of the impaired reperfusion in patients with STEMI. TheMVO depends on the size of the infarct area. The LV function recovery andremodeling within the first 4 m. after mechanically reperfused STEMI areinfluenced by the baseline LV functional and structural condition and the extentof myocardial damage.
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Data ostatniej modyfikacji:
20 mar 2023
Data dodania obiektu:
7 kwi 2014
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http://dl.cm-uj.krakow.pl:8080/publication/3671
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| Nazwa wydania | Data |
|---|---|
| ZB-120427 | 20 mar 2023 |
Obiekty
Podobne
Durak, Monika
Andres, Marek
Zajdel, Wojciech J.
Węgiel, Michał Jan
Zorkun, Cafer Sadik
Gąsior,Mariusz (oprac ).
Dziewięcka, Ewa Maria
