Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease
Objective: The aim of this study was to investigate the impact of admission systolic blood pressure (ASBP) and left ventricular (LV) mass on the postreperfusion LV recovery in patients with ST-segment elevation myocardial infarction (STEMI) and concomitant coronary multivessel disease (MVD). Materia...
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doaj-c8054803222b412c969dbf844c0eadc32020-11-24T21:34:58ZengMDPI AGMedicina1010-660X2015-01-01511384510.1016/j.medici.2015.01.005Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery diseaseEdvardas Vaicekavičius0Donatas Vasiliauskas1Ramūnas Navickas2Irena Milvidaitė3Ramūnas Unikas4Jonė Venclovienė5Raimondas Kubilius6Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LithuaniaDepartment of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LithuaniaDepartment of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LithuaniaObjective: The aim of this study was to investigate the impact of admission systolic blood pressure (ASBP) and left ventricular (LV) mass on the postreperfusion LV recovery in patients with ST-segment elevation myocardial infarction (STEMI) and concomitant coronary multivessel disease (MVD). Materials and methods: A retrospective analysis of 12-month postreperfusion LV recovery was performed in 104 patients after primary percutaneous coronary intervention (PPCI). Patients with elevated ASBP (>140 mmHg) were assigned to the first group (n = 58); with normal ASBP (<140 mmHg), to the second group (n = 46); with increased myocardial mass index (MMI) (>100 g/m2), to the third group (n = 70); and with normal MMI (<100 g/m2), to the fourth group (n = 34). Severity of MVD was evaluated by the Syntax score. The LV recovery was assessed by evolution of quantitative characteristics of electrocardiography (QRS score, ST score, ECG STEMI stage) and echocardiography (LV ejection fraction, volume and mass indices) registered before and after PPCI, at discharge, and after 1, 6, and 12 months. Results: There were no significant differences in the baseline QRS and ST scores, ECG STEMI stage, LVEF, MMI, and Syntax score comparing all the patients’ groups. The serial ECG criteria showed only a very small impact of ASBP on postreperfusion LV recovery. Only ECG STEMI stage progression was slower in the patients with elevated ASBP. In patients with different MMI, the QRS and ST scores were higher and ECG STEMI stage was lower in patients with increased MMI. LVEF after 1 year was significantly lower in the third group as compared to the fourth group (42.58% ± 8.25% vs. 46.8% ± 7.13%, P = 0.018). Conclusion: Postreperfusion LV recovery was more related not to ASBP but to the increased LV mass assessed by echocardiography in patients with STEMI and MVD.http://www.sciencedirect.com/science/article/pii/S1010660X15000063Primary percutaneous coronary interventionMultivessel coronary artery diseasePostreperfusion left ventricle recoveryLeft ventricular function |
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Edvardas Vaicekavičius Donatas Vasiliauskas Ramūnas Navickas Irena Milvidaitė Ramūnas Unikas Jonė Venclovienė Raimondas Kubilius |
spellingShingle |
Edvardas Vaicekavičius Donatas Vasiliauskas Ramūnas Navickas Irena Milvidaitė Ramūnas Unikas Jonė Venclovienė Raimondas Kubilius Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease Medicina Primary percutaneous coronary intervention Multivessel coronary artery disease Postreperfusion left ventricle recovery Left ventricular function |
author_facet |
Edvardas Vaicekavičius Donatas Vasiliauskas Ramūnas Navickas Irena Milvidaitė Ramūnas Unikas Jonė Venclovienė Raimondas Kubilius |
author_sort |
Edvardas Vaicekavičius |
title |
Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease |
title_short |
Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease |
title_full |
Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease |
title_fullStr |
Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease |
title_full_unstemmed |
Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease |
title_sort |
impact of hypertension on postreperfusion left ventricular recovery in patients with st-segment elevation myocardial infarction and multivessel coronary artery disease |
publisher |
MDPI AG |
series |
Medicina |
issn |
1010-660X |
publishDate |
2015-01-01 |
description |
Objective: The aim of this study was to investigate the impact of admission systolic blood pressure (ASBP) and left ventricular (LV) mass on the postreperfusion LV recovery in patients with ST-segment elevation myocardial infarction (STEMI) and concomitant coronary multivessel disease (MVD).
Materials and methods: A retrospective analysis of 12-month postreperfusion LV recovery was performed in 104 patients after primary percutaneous coronary intervention (PPCI). Patients with elevated ASBP (>140 mmHg) were assigned to the first group (n = 58); with normal ASBP (<140 mmHg), to the second group (n = 46); with increased myocardial mass index (MMI) (>100 g/m2), to the third group (n = 70); and with normal MMI (<100 g/m2), to the fourth group (n = 34). Severity of MVD was evaluated by the Syntax score. The LV recovery was assessed by evolution of quantitative characteristics of electrocardiography (QRS score, ST score, ECG STEMI stage) and echocardiography (LV ejection fraction, volume and mass indices) registered before and after PPCI, at discharge, and after 1, 6, and 12 months.
Results: There were no significant differences in the baseline QRS and ST scores, ECG STEMI stage, LVEF, MMI, and Syntax score comparing all the patients’ groups. The serial ECG criteria showed only a very small impact of ASBP on postreperfusion LV recovery. Only ECG STEMI stage progression was slower in the patients with elevated ASBP. In patients with different MMI, the QRS and ST scores were higher and ECG STEMI stage was lower in patients with increased MMI. LVEF after 1 year was significantly lower in the third group as compared to the fourth group (42.58% ± 8.25% vs. 46.8% ± 7.13%, P = 0.018).
Conclusion: Postreperfusion LV recovery was more related not to ASBP but to the increased LV mass assessed by echocardiography in patients with STEMI and MVD. |
topic |
Primary percutaneous coronary intervention Multivessel coronary artery disease Postreperfusion left ventricle recovery Left ventricular function |
url |
http://www.sciencedirect.com/science/article/pii/S1010660X15000063 |
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