Left Ventricular Function and Infarct Size 20 Months after Primary Angioplasty for Acute Myocardial Infarction

Authors: Halvorsen S.¹; Müller C.²; Bendz B.¹; Eritsland J.¹; Brekke M.¹; Mangschau A.¹

Source: Scandinavian Cardiovascular Journal, Volume 35, Number 6, 1 December 2001 , pp. 379-384(6)

Publisher: Informa Healthcare

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Abstract:

Objective—To study changes in left ventricular function and infarct size during long-term follow-up after acute myocardial infarction treated with primary angioplasty. Design—From 1996 to 1998, 100 consecutive patients were treated with primary angioplasty for acute ST-elevation myocardial infarction. Angioplasty was successful in 95% of the patients. Global left ventricular ejection fraction (LVEF) was determined by radionuclide ventriculography before discharge, after 6 weeks and after a mean follow-up time of 20 months. Infarct size was assessed by technetium 99m-tetrofosmin myocardial perfusion tomography (SPECT) at rest, performed at the same time intervals. Results—Mean LVEF was 56% at discharge, 55% after 6 weeks and 57% after 20 months of follow-up. No significant improvement in LVEF was observed. Only 8% of the patients at follow-up had LVEF lower than 40%. After 1 week, a mean perfusion defect of 19% was measured by SPECT. After 6 weeks and 20 months of follow-up, the mean perfusion defects were reduced to 14% (p < 0.001) and 15%, respectively. Conclusion—Left ventricular function was well preserved with a mean LVEF of 57% 20 months after primary angioplasty for acute myocardial infarction. No significant change in LVEF was observed from 1 week after angioplasty to follow-up. Infarct sizes as assessed by SPECT imaging with tetrofosmin were reduced from 1 to 6 weeks, but did not change further during long-term follow-up. The reduction in the perfusion defects over time was probably due to gradual relief of stunning.

Keywords: ACUTE MYOCARDIAL INFARCTION; LEFT VENTRICULAR EJECTION FRACTION; MYOCARDIAL PERFUSION; PRIMARY ANGIOPLASTY; STUNNING

Language: English

Document Type: Research article

Affiliations: 1: Heart–Lung Center, Ullevaal University Hospital 2: Radiological Division, Ullevaal University Hospital, Oslo, Norway

Publication date: 2001-12-01

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