A comparision of left ventricular functions after acute myocardial infarction receiving different reperfusion therapy

Year 2018, Volume: 35 Issue: 1, 1 - 6, 25.10.2019

İhsan Dursun

Abstract

Background:
It is demonstrated that primary angioplasty is more effective than thrombolytic
therapy on the clinical outcomes in ST- segment elevation acute myocardial
infarction (STEMI). The aim of this study was to compare the effects of reperfusion
therapies on left ventricular systolic and diastolic functions.

Methods:
We assigned 114 patients (19 female, mean age 60.2 ± 10.7 years, and 95 male,
mean age 53.6 ± 11.0 years) with first STEMI treated with primary angioplasty
(n=54) or thrombolytic drug therapy (n=60) in accordance with selection
criteria. Assesment of LV systolic function was done by wall motion score index
(WMSI) and left ventricular ejection fraction( LVEF). Left ventricular
diastolic function was evaluated by the pulsed Doppler technique

Results: WMSI
was significantly lower in angioplasty group 
(1.31 ± 0.30) compared to thrombolysis group (1.45 ± 0.40)  (P<0.01). LVEF did not differ between
treatment groups (50 ± 9 % vs 47 ± 8 %, 
P>0.05). The frequency of diastolic dysfunction tended to lower in
angioplasty group but the difference was not significant (50% vs 62%,
P>0.05). Nevertheless, rates of restrictive filling pattern cases was
significantly higher in thrombolysis group ( 7% vs 22%, P<0.05 ). There was
a significant difference for E/A ratio between two groups (0.99± 0.38 versus
1.20± 0.60, P<0.05).

Conclusions:
The results showed that the left ventricular systolic and diastolic functions
were preserved with STEMI treated by primary angioplasty. This may contribute
to better clinical outcomes in patients with STEMI treated with primary
angioplasty.  

Keywords

Primary angioplasty, acute myocardial infarction, left ventricular function, restrictive filling pattern

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