[Effects of delayed opening of infarct-related artery on late left ventricular remodeling in patients with acute anterior myocardial infarction].
OBJECTIVE
To assess the effect of delayed opening of the infarct-related artery (IRA) by percutaneous coronary intervention (PCI) on the late left ventricular remodeling after acute anterior myocardial infarction (AAMI).


METHODS
Sixty four patients with initial Q-wave AAMI and with the total occluded IRA conformed by angiogram at 9.1 +/- 2.3 (2 - 14) days after the onset were divided into successful PCI group and control group (not receiving PCI or the IRA not re-opened). Two-D echocardiogram was performed at acute phase (about 3 weeks), 2 and 6 months after onset of AAMI respectively to detect the left ventricular function and left ventricular wall motion abnormality (VWMA). The total congestive heart failure events were recorded during 6 months follow-up.


RESULTS
VWMA scores, left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volume indexes (LVEDVI and LVESVI) were similar in 2 groups at acute phase and 2 months after the onset of AAMI. There were no differences between the parameters above at acute phase and 2 months in each group too. VWMA scores and LVEF did not changed significantly at 6 months in each group compared with those at acute phase and 2 months (P > 0.05). But LVEDVI and LVESVI were significantly smaller in the successful PCI group than those in the control group (P < 0.01, P < 0.05). The rate of congestive heart failure events was 19% in control group and 2.0% in successful PCI group (P > 0.05) respectively.


CONCLUSIONS
Delayed opening of IRA in AAMI could prevent the late phase but not the early phase of left ventricular remodeling after AMI.
Ma
Li-kun
LK
Department of Cardiology, Anhui Provincial Hospital, Hefei 230001, China. Malk2002cn@yahoo.com.cn
Yu
Hua
H
Huang
Xiang-yang
XY
Zhu
Jun
J
Feng
Ke-fu
KF
Li
Shi-guang
SG
Zhang
Xiao-hong
XH
Shao
Zheng-bin
ZB
Ding
Xiao-mei
XM
Yan
Ji
J
Gu
Tong-yuan
TY
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D015425:Myocardial Reperfusion; D020257:Ventricular Remodeling