Myocardial Perfusion Grade by Coronary Angiography can Predict Final Infarct Size and Left Ventricular Function in Patients with ST-elevation Myocardial Infarction Treated with a Pharmaco-invasive Strategy

Open Access Macedonian Journal of Medical Sciences

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Title Myocardial Perfusion Grade by Coronary Angiography can Predict Final Infarct Size and Left Ventricular Function in Patients with ST-elevation Myocardial Infarction Treated with a Pharmaco-invasive Strategy
 
Creator Ahmed, Amal Hafez
ELHadidy, Amr
Helmy, Mohamed
Hussein, Ashraf
Elagha, Abdalla
 
Subject ST-elevation myocardial infarction
Percutaneous coronary intervention
Myocardial perfusion grade
Infarct size
Perfusion study
 
Description BACKGROUND: Primary percutaneous coronary intervention (PCI) is the reperfusion strategy of choice in ST-elevation myocardial infarction (STEMI). Transfer for early angioplasty after thrombolytic therapy should be done without delay and has been directly related to improved patients’ outcome compared with thrombolysis alone. TIMI myocardial perfusion (TMP) grade provides important prognostic information for epicardial flow.
AIM: We studied the relationship between TMP grade (at the end of the PCI procedure) and left ventricular ejection fraction (LVEF) and infarct size within 1 month in such patients.
METHODS: A total of forty patients with diagnosis of STEMI (mean age 57.32 ± 10.44, 33 men) were studied, all patients underwent primary PCI. Grading of myocardial perfusion was done immediately post-PCI. Infarction size, end-diastolic volume (EDV), end-systolic volume (ESV), and LVEF were all measured by myocardial perfusion imaging (Gated single-photon emission computed tomography) within 1 month of STEMI.
RESULTS: Final infarct size ranged from 0 to 59 cm (mean =19.18 ± 15.8 cm). EDV ranged from 52 to 228 ml (mean = 128.60 ± 51.01 ml). ESV ranged from 16 to 169 ml (mean =72.05 ± 42.09 ml) and EF ranged from 21% to 72% (mean = 46.0 ± 12.80%). Viable but ischemic myocardial area ranged from 0 to 18 cm (mean =3.38 ± 4.45 cm). There was a significant “negative” correlation between the myocardial perfusion grade and the final infarct size. Furthermore, myocardial perfusion grade was significantly inversely related to EDV and ESV, but directly related to EF. Patients who received thrombolytic therapy had significant lesser perfusion grade than who underwent PCI directly.
CONCLUSION: Assessment of the myocardial perfusion grade during PCI is a good prognostic marker about the final infarct size, ESV, EDV, and EF in patients with STEMI treated with a pharmaco-invasive strategy (thrombolytic followed by PCI).
 
Publisher Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia
 
Date 2021-03-01
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
 
Identifier https://www.id-press.eu/mjms/article/view/5815
10.3889/oamjms.2021.5815
 
Source Open Access Macedonian Journal of Medical Sciences; Vol. 9 No. B (2021): B - Clinical Sciences; 184-190
1857-9655
 
Language eng
 
Relation https://www.id-press.eu/mjms/article/view/5815/5462
 
Rights Copyright (c) 2021 Amal Hafez Ahmed, Amr ELHadidy, Mohamed Helmy, Ashraf Hussein, Abdalla Elagha (Author)
http://creativecommons.org/licenses/by-nc/4.0
 

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