Late coronary artery recanalization effects on left ventricular remodelling and contractility by magnetic resonance imaging.
OBJECTIVE
To assess the recanalization effects of post-myocardial infarction (MI) on left ventricular (LV) remodelling and contractility in relation to conservative therapy.


RESULTS
Thirty-six patients with occluded infarct-related artery between 12 h and 14 days post-anterior MI were randomized to percutaneous coronary intervention (PCI group) or conservative therapy (no-PCI group). Magnetic resonance imaging was performed at enrollment and after 6 months. The left ventricle was divided into infarct, adjacent, and remote segments. There was no difference in relation to LV volume between groups at the 6 month follow-up. Change in LV ejection fraction was favourable to the PCI group: 5.00% vs. -0.76%, P=0.012. Change in circumferential shortening (Ecc) of the remote segments in the PCI group was significantly better than in the no-PCI group: -1.67+/-6.30% vs. 0.29+/-6.02%, P<0.001. Infarct size and LV mass were similar between groups.


CONCLUSIONS
Late recanalization improved LV ejection fraction and myocardial contractility in late follow-up, but did not change the ventricular volumes. Improvement in the left ventricle global and regional contractility may benefit the long-term outcome in post-MI patients with sustained patency of the infarct-related artery.
Silva
João C
JC
Acute Coronary Disease Unit, Heart Institute (InCor), University of São Paulo Medical School, Av. Enéas de Carvalho de Aguiar, 44, 2nd Floor, 05403-000, São Paulo, Brazil. joaoclima@uol.com.br
Rochitte
Carlos E
CE
Júnior
José S
JS
Tsutsui
Jeanne
J
Andrade
Joalbo
J
Martinez
Eulógio E
EE
Moffa
Paulo J
PJ
Menegheti
José C
JC
Kalil-Filho
Roberto
R
Ramires
José F
JF
Nicolau
José C
JC
D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D020257:Ventricular Remodeling / Q000502:physiology*