Long-term follow up of left ventricular remodeling in ST segment myocardial infarction patients after primary percutaneous coronary intervention

Abstract

Introduction The adaptive reaction known as left ventricular remodeling after ST-elevation myocardial infraction (STEMI) involves both the infarct zone and remote zones, and it lasts for at least 2 years after STEMI. In STEMI patients having primary percutaneous coronary intervention (PPCI), this study was conducted to look at long-term consequences of left ventricular remodeling. Patients and methods Ninety-three patients were successfully treated by primary PCI more than 2 years ago at Assiut University Heart Hospital were enrolled in this study. Detailed history, complete general examination and local cardiac examination were done. Electrocardiography, two-dimensional echocardiography before primary PCI, at discharge and 6 months after PPCI, coronary angiographic and PPCI data from patient admission sheet. Patients were examined by transthoracic 2DE using Phillips ie33 ultrasound system device. Results Thirty-six (38.7%) patients were determined to have left ventricular remodeling when their left ventricular end diastolic volume index increased by more than 20%, compared with 57 (61.3%) patients who did not. Mean age of patients 56.31 ± 11.11 years and mean overall duration of follow up was 3.69 ± 0.45 years. The long-term predictors of left ventricular remodeling were: extensive anterior MI (P < 0.001), left anterior descending as infarct-related artery (P = 0.03), left ventricular end systolic volume index (P = 0.04) and wall motion index (P < 0.001). Discussion Patients who had extensive anterior MI, a wall motion score index more than 1.5, and left anterior descending as infarct-related artery were seen as having a high probability of LV remodeling following PPCI. Only wall motion score index more than 1.5 and extensive anterior MI were independent indicators of LV remodeling following PPCI.