AI Article Synopsis

  • The study aimed to evaluate how delaying the opening of the infarct-related artery (IRA) impacts late left ventricular remodeling following an acute anterior myocardial infarction (AAMI).
  • Sixty-four patients were divided into two groups: one receiving successful percutaneous coronary intervention (PCI) and the other not receiving PCI, with their heart function monitored at multiple intervals post-AAMI.
  • Results indicated that while early metrics like left ventricular function were similar across both groups, those in the successful PCI group experienced significantly less increase in heart chamber sizes and a lower incidence of congestive heart failure events over six months.

Article Abstract

Objective: To assess the effect of delayed opening of the infarct-related artery (IRA) by percutaneous coronary intervention (PCI) on the late left ventricular remodeling after acute anterior myocardial infarction (AAMI).

Methods: Sixty four patients with initial Q-wave AAMI and with the total occluded IRA conformed by angiogram at 9.1 +/- 2.3 (2 - 14) days after the onset were divided into successful PCI group and control group (not receiving PCI or the IRA not re-opened). Two-D echocardiogram was performed at acute phase (about 3 weeks), 2 and 6 months after onset of AAMI respectively to detect the left ventricular function and left ventricular wall motion abnormality (VWMA). The total congestive heart failure events were recorded during 6 months follow-up.

Results: VWMA scores, left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volume indexes (LVEDVI and LVESVI) were similar in 2 groups at acute phase and 2 months after the onset of AAMI. There were no differences between the parameters above at acute phase and 2 months in each group too. VWMA scores and LVEF did not changed significantly at 6 months in each group compared with those at acute phase and 2 months (P > 0.05). But LVEDVI and LVESVI were significantly smaller in the successful PCI group than those in the control group (P < 0.01, P < 0.05). The rate of congestive heart failure events was 19% in control group and 2.0% in successful PCI group (P > 0.05) respectively.

Conclusions: Delayed opening of IRA in AAMI could prevent the late phase but not the early phase of left ventricular remodeling after AMI.

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