Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI – A non-invasive evaluation by echocardiography
Background: It is well established fact that acute coronary occlusion leads to diastolic dysfunction, followed by systolic dysfunction when myonecrosis occur. It is also proven that primary percutaneous coronary intervention (PPCI) is an excellent therapy for ST elevation myocardial infarction (STEM...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-12-01
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| Series: | The Egyptian Heart Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1110260818301200 |
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| author | Siva Subramaniyan Neeraj Pandit Ranjit Kumar Nath Ajay Raj Athar Kamal Deepankar Vatsa |
| author_facet | Siva Subramaniyan Neeraj Pandit Ranjit Kumar Nath Ajay Raj Athar Kamal Deepankar Vatsa |
| author_sort | Siva Subramaniyan |
| collection | DOAJ |
| description | Background: It is well established fact that acute coronary occlusion leads to diastolic dysfunction, followed by systolic dysfunction when myonecrosis occur. It is also proven that primary percutaneous coronary intervention (PPCI) is an excellent therapy for ST elevation myocardial infarction (STEMI) to improve outcomes. However there is a paucity of information on efficacy of PPCI in improving diastolic function. Evaluation of the role of PPCI in improving diastolic dysfunction is required. Methods: 61 patients with first anterior wall STEMI who underwent PPCI to left anterior descending artery were included. Echocardiographic evaluation was performed within 24 h of PPCI and then on day 15, 3 months and 6 months after PPCI. We evaluated the prevalence of diastolic dysfunction after PPCI and its recovery during 6 months along with effect of duration of chest pain on diastolic function. Results: 54.1% of patients had diastolic dysfunction after PPCI whereas it was only 21.3% after 6 months (p value < 0.001). Diastolic function indices like deceleration time, isovolumic relaxation time, E wave, A wave, E/A ratio, left atrial volume and index improved statistically from baseline to 6 months except mitral E/e′ ratio. As time required to achieve reperfusion increases (chest pain duration and D to B time) the incidence of residual diastolic dysfunction also increases (p value < 0.001). Patients with TIMI flow < III had more diastolic dysfunction (p value < 0.001). Conclusions: Primary PCI improves diastolic dysfunction in patients with anterior wall STEMI over a period of 6 months. Time to achieve reperfusion and effectiveness of reperfusion have significant effect on diastolic dysfunction. Keywords: Deceleration time, Diastolic dysfunction, Isovolumic relaxation time, Primary percutaneous coronary intervention, ST elevation myocardial infarction |
| first_indexed | 2024-04-12T03:53:28Z |
| format | Article |
| id | doaj.art-f5b56473b6974233af31c356497c2d75 |
| institution | Directory Open Access Journal |
| issn | 1110-2608 |
| language | English |
| last_indexed | 2024-04-12T03:53:28Z |
| publishDate | 2018-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-f5b56473b6974233af31c356497c2d752022-12-22T03:48:56ZengSpringerOpenThe Egyptian Heart Journal1110-26082018-12-01704427432Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI – A non-invasive evaluation by echocardiographySiva Subramaniyan0Neeraj Pandit1Ranjit Kumar Nath2Ajay Raj3Athar Kamal4Deepankar Vatsa5Corresponding author at: Department of Cardiology, PGIMER and Dr Ram Manohar Lohia Hospital, Connaught Place, New Delhi 110001, India.; Department of Cardiology, Guru Gobind Singh Indraprastha University, IndiaDepartment of Cardiology, Guru Gobind Singh Indraprastha University, IndiaDepartment of Cardiology, Guru Gobind Singh Indraprastha University, IndiaDepartment of Cardiology, Guru Gobind Singh Indraprastha University, IndiaDepartment of Cardiology, Guru Gobind Singh Indraprastha University, IndiaDepartment of Cardiology, Guru Gobind Singh Indraprastha University, IndiaBackground: It is well established fact that acute coronary occlusion leads to diastolic dysfunction, followed by systolic dysfunction when myonecrosis occur. It is also proven that primary percutaneous coronary intervention (PPCI) is an excellent therapy for ST elevation myocardial infarction (STEMI) to improve outcomes. However there is a paucity of information on efficacy of PPCI in improving diastolic function. Evaluation of the role of PPCI in improving diastolic dysfunction is required. Methods: 61 patients with first anterior wall STEMI who underwent PPCI to left anterior descending artery were included. Echocardiographic evaluation was performed within 24 h of PPCI and then on day 15, 3 months and 6 months after PPCI. We evaluated the prevalence of diastolic dysfunction after PPCI and its recovery during 6 months along with effect of duration of chest pain on diastolic function. Results: 54.1% of patients had diastolic dysfunction after PPCI whereas it was only 21.3% after 6 months (p value < 0.001). Diastolic function indices like deceleration time, isovolumic relaxation time, E wave, A wave, E/A ratio, left atrial volume and index improved statistically from baseline to 6 months except mitral E/e′ ratio. As time required to achieve reperfusion increases (chest pain duration and D to B time) the incidence of residual diastolic dysfunction also increases (p value < 0.001). Patients with TIMI flow < III had more diastolic dysfunction (p value < 0.001). Conclusions: Primary PCI improves diastolic dysfunction in patients with anterior wall STEMI over a period of 6 months. Time to achieve reperfusion and effectiveness of reperfusion have significant effect on diastolic dysfunction. Keywords: Deceleration time, Diastolic dysfunction, Isovolumic relaxation time, Primary percutaneous coronary intervention, ST elevation myocardial infarctionhttp://www.sciencedirect.com/science/article/pii/S1110260818301200 |
| spellingShingle | Siva Subramaniyan Neeraj Pandit Ranjit Kumar Nath Ajay Raj Athar Kamal Deepankar Vatsa Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI – A non-invasive evaluation by echocardiography The Egyptian Heart Journal |
| title | Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI – A non-invasive evaluation by echocardiography |
| title_full | Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI – A non-invasive evaluation by echocardiography |
| title_fullStr | Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI – A non-invasive evaluation by echocardiography |
| title_full_unstemmed | Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI – A non-invasive evaluation by echocardiography |
| title_short | Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI – A non-invasive evaluation by echocardiography |
| title_sort | acute effect of primary pci on diastolic dysfunction recovery in anterior wall stemi a non invasive evaluation by echocardiography |
| url | http://www.sciencedirect.com/science/article/pii/S1110260818301200 |
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