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E-ISSN : 2148-9696
Crescent Journal of
Medical and Biological Sciences
Jan 2019, Vol 6, Issue 1
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Original Article
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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Abstract

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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Articles by Toufan Tabrizi M
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Aras Part Medical International Press Editors in Chief
Arash Khaki
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Zafer Akan Deputy Editor
Javadi, Leila
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