|Prevalence and Predictors of Left Ventricle Regional Wall Motion Abnormality (RWMA) Six Weeks After Primary Percutaneous Intervention (PPCI) in Patients with First Acute Anterior Myocardial Infarction (MI)|
|Mehrnoush Toufan Tabrizi1, Sakine Hadi1, Ahmad Separham1, Mohammadreza Hoseinalizade1, Marzie Sadeghi1|
|1Department Of Cardiology, Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran|
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Objectives: Regional wall motion abnormality (RWMA) takes place after acute myocardial infarction, even after primary percutaneous coronary intervention (PPCI). There are controversies over the correlation between early ventricular wall dysfunction and long term prognosis .The aim of the study was to assess the prevalence and to define the baseline clinical , angiographic and echocardiographic predictors of RWMA after PPCI in patients with acute anterior MI.
Materials and Methods: Of the 110 patients initially selected for the study 107 (85 men and 22 women , mean age 58.21±11.64 years ) with first anterior MI treated with primary PCI were evaluated. Transthoracic echocardiographic examination was performed at admission time and after at least 6weeks..The RWMA was assessed and WMSI was calculated by dividing sum of the wall motion score over the number of visualized segments.
Results: Ninety-one patients (85%) had a positive RWMA. The mean time of the symptom-onset to balloon and door to balloon were 307.27±275.26 and 68.96±81.97 minutes, respectively.It was revealed no statistically significant association between symptom-onset to balloon time and door to balloon time compared with WMSI value (p=0.29 , r:0.105) (p=0.53 , r:-0.062) For post-PPCI TIMI flow grades, the patients with a grade II and III TIMI flow had a mean WMSI value of 1.90±0.39and 1.65±0.31, respectively, that was significantly higher in patients with a grade II TIMI flow (p= 0.002). During follow-up echocardiography , 84(79.2%) patients had a positive RWMA. Follow-up positive RWMA was significantly lower (7.4%) in patients suffered from stable angina(p= 0.01). Statistically noticeable improvements in the level of WMSI and E/E’ ratio during the follow up period of echocardiography were reported..Also there was significant relation between pre and post-PCI LVESV and WMSI compared with post-PCI RWMA (p=0.03 , p<0.0001), (p=0.007 , p<0.0001)However, no statistically significant differences were observed in the demographic data and MI risk factors considering the incidence of RWMA and the mean value of WMSI.
Conclusion: In patients with the first acute MI , higher WMS index and LVESV level are strongly related to the RWMA incidence after six weeks which could be applied as predictor factors of RWMA incidence.
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