Comparison of the left ventricular electromechanical map before percutaneous coronary stent revascularization and at one-month follow-up in patients with a recent ST elevation infarction.
The study aimed to evaluate the safety and potential of percutaneous transluminal electromechanical mapping (NOGA) in patients with regional myocardial wall dysfunction after a recent ST elevation myocardial infarction (STEMI). Regional myocardial wall dysfunction is a major cause of morbidity in survivors of ST elevation myocardial infarction. Fifteen males who recently had suffered a STEMI were studied prospectively with coronary angiography, ventriculography, and NOGA before and 1 month after percutaneous coronary intervention (PCI). The left ventricular angiographic ejection fraction increased from 50% +/- 11% before PCI to 56% +/- 10% at follow-up (P = 0.006). Qualitative analysis of the NOGA color map identified and outlined an area of regional wall dysfunction in all patients. Quantitative analysis of the NOGA maps showed improvements at follow-up after PCI in regional wall parameters of the infarct area (bipolar voltage: 1.7 +/- 1.4 mV before intervention, 2.2 +/- 1.6 mV at follow-up, P = 0.05; local shortening, a NOGA parameter on wall motion: 3.5% +/- 6.2% before, 7.4% +/- 5.8% at follow-up, P = 0.01), whereas there were no changes in the noninfarcted area (bipolar voltage: 2.7 +/- 2.5 mV before intervention, 2.8 +/- 2.6 mV at follow-up, P = 0.99; local shortening: 7.8% +/- 7.8% before, 8.2% +/- 7.8% at follow-up, P = 0.99). There were no complications to the NOGA procedures. In patients treated with PCI for a recent STEMI, NOGA might be considered used in the quantification of myocardial recovery and in the outlining of myocardial areas of incomplete or no recovery.
Jørgensen
Erik
E
Cardiac Catheterization Laboratory, The Heart Center, Rigshospitalet, Copenhagen, Denmark. erijk@rh.dk
Madsen
Theis
T
Kastrup
Jens
J
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D018780:Body Surface Potential Mapping / Q000379:methods*; D017023:Coronary Angiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology* / Q000628:therapy