title: Acute left ventricular dynamic effects of primary percutaneous coronary intervention from occlusion to reperfusion.
abstract: OBJECTIVE
  We studied the left ventricular (LV) dynamic effects of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) by directly obtaining pressure-volume (PV) loops during the procedure.
  
  
  BACKGROUND
  An acute myocardial infarction causes a decrease in LV compliance. The instantaneous effects of primary PCI on LV compliance are unknown.
  
  
  METHODS
  We studied 15 consecutive patients (10 males, ages 59 +/- 12 years), who presented with their first acute anterior STEMI within 6 h after onset of symptoms, and in whom coronary angiography revealed an occluded left anterior descending coronary artery. Before performing primary PCI, we inserted a pressure-conductance catheter in the LV to continuously obtain PV loops.
  
  
  RESULTS
  Immediately after successful reperfusion, significant improvements were observed in LV diastolic function, as indicated by an increased end-diastolic compliance with a 6.0 +/- 2.8 mm Hg (p < 0.0001) downward shift of the compliance curve. There was a decrease in end-diastolic pressure of 24 +/- 18% (p = 0.0002), in stiffness of 27 +/- 18% (p = 0.0003), and in wall stress of 20 +/- 24% (p = 0.004). Systolic function mainly showed an immediate improvement in apical contractility from 40 +/- 17% to 54 +/- 15% (p = 0.01).
  
  
  CONCLUSIONS
  Primary PCI in anterior STEMI patients causes an immediate improvement in diastolic function, assessed by online PV loop measurements.
authors.affiliation: Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: Maurice
authors.initials: M
authors.lastname: Remmelink
authors.forename: Krischan D
authors.initials: KD
authors.lastname: Sjauw
authors.forename: José P S
authors.initials: JP
authors.lastname: Henriques
authors.forename: Marije M
authors.initials: MM
authors.lastname: Vis
authors.forename: René J
authors.initials: RJ
authors.lastname: van der Schaaf
authors.forename: Karel T
authors.initials: KT
authors.lastname: Koch
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.forename: Jan
authors.initials: J
authors.lastname: Baan
mesh_terms: D000208:Acute Disease; D015906:Angioplasty, Balloon, Coronary; D002302:Cardiac Output; D003971:Diastole; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D011446:Prospective Studies; D013318:Stroke Volume; D013599:Systole; D016277:Ventricular Function, Left