title: Reperfusion phenomenon is a strong predictor of left ventricular remodeling after acute myocardial infarction.
abstract: BACKGROUND
  Many clinicians have seen the reperfusion phenomenon, a paradoxical response that includes a transient increase of chest pain, additional ST-segment elevation or ventricular arrhythmias immediately after coronary reperfusion, in patients with acute myocardial infarction (AMI). The aim of the present study was to investigate the impact of this phenomenon during coronary reperfusion on left ventricular (LV) remodeling in patients with AMI.
  
  
  RESULTS
  One hundred and thirty-eight consecutive patients with a first anterior-wall AMI, undergoing coronary reperfusion treatment within 24 h of onset were prospectively evaluated for reperfusion phenomenon and followed up with scheduled evaluations of LV function and morphology with left ventriculography for 1 year. Of the 138 enrolled patients, 77 underwent serial left ventriculography at the acute, subacute and 1-year phases. Of these 77 patients, 39 demonstrated the reperfusion phenomenon. The LV end-diastolic volume index significantly increased from the acute to subacute phase and to the 1-year phase, but was unchanged in the 38 patients without reperfusion phenomenon. In multivariate analysis, reperfusion phenomenon was the only determinant of LV dilatation after AMI.
  
  
  CONCLUSIONS
  Reperfusion phenomenon was a strong predictor of LV remodeling after reperfusion therapy for AMI.
authors.affiliation: Department of Cardiology, the Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan. douki@sm.rim.or.jp
authors.forename: Michitaka
authors.initials: M
authors.lastname: Nagashima
authors.forename: Akira
authors.initials: A
authors.lastname: Itoh
authors.forename: Masato
authors.initials: M
authors.lastname: Otsuka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kasanuki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Haze
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D015425:Myocardial Reperfusion; D020257:Ventricular Remodeling