Infarct Size as Predictor of Systolic Functional Recovery after Myocardial Infarction

• Main Authors: Marcos F. Minicucci, Elaine Farah, Daniéliso R. Fusco, Ana Lúcia Cogni, Paula S. Azevedo, Katashi Okoshi, Silméia G. Zanati, Beatriz B. Matsubara, Sergio A. R. Paiva, Leonardo A. M. Zornoff
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Cardiologia (SBC) 2014-06-01
• Series: Arquivos Brasileiros de Cardiologia
• Subjects: Infarto do miocárdio; Insuficiência cardíaca; Disfunção ventricular; Recuperação de função fisiológica
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014000600004&lng=en&tlng=en

Background: The effects of modern therapy on functional recovery after acute myocardial infarction (AMI) are unknown.Objectives:To evaluate the predictors of systolic functional recovery after anterior wall AMI in patients undergoing modern therapy (reperfusion, aggressive platelet antiaggregant therapy, angiotensin-converting enzyme inhibitors and beta-blockers).Methods:A total of 94 consecutive patients with AMI with ST-segment elevation were enrolled. Echocardiograms were performed during the in-hospital phase and after 6 months. Systolic dysfunction was defined as ejection fraction value < 50%.Results:In the initial echocardiogram, 64% of patients had systolic dysfunction. Patients with ventricular dysfunction had greater infarct size, assessed by the measurement of total and isoenzyme MB creatine kinase enzymes, than patients without dysfunction. Additionally, 24.5% of patients that initially had systolic dysfunction showed recovery within 6 months after AMI. Patients who recovered ventricular function had smaller infarct sizes, but larger values of ejection fraction and E-wave deceleration time than patients without recovery. At the multivariate analysis, it can be observed that infarct size was the only independent predictor of functional recovery after 6 months of AMI when adjusted for age, gender, ejection fraction and E-wave deceleration time.Conclusion: In spite of aggressive treatment, systolic ventricular dysfunction remains a frequent event after the anterior wall myocardial infarction. Additionally, 25% of patients show functional recovery. Finally, infarct size was the only significant predictor of functional recovery after six months of acute myocardial infarction.