title: Infarct size as predictor of systolic functional recovery after myocardial infarction.
abstract: BACKGROUND
  The effects of modern therapy on functional recovery after acute myocardial infarction (AMI) are unknown.
  
  
  OBJECTIVE
  To evaluate the predictors of systolic functional recovery after anterior wall AMI in patients undergoing modern therapy (reperfusion, aggressive platelet antiaggregant therapy, angiotensin-converting enzyme inhibitors and beta-blockers).
  
  
  METHODS
  A total of 94 consecutive patients with AMI with ST-segment elevation were enrolled. Echocardiograms were performed during the in-hospital phase and after 6 months. Systolic dysfunction was defined as ejection fraction value < 50%.
  
  
  RESULTS
  In the initial echocardiogram, 64% of patients had systolic dysfunction. Patients with ventricular dysfunction had greater infarct size, assessed by the measurement of total and isoenzyme MB creatine kinase enzymes, than patients without dysfunction. Additionally, 24.5% of patients that initially had systolic dysfunction showed recovery within 6 months after AMI. Patients who recovered ventricular function had smaller infarct sizes, but larger values of ejection fraction and E-wave deceleration time than patients without recovery. At the multivariate analysis, it can be observed that infarct size was the only independent predictor of functional recovery after 6 months of AMI when adjusted for age, gender, ejection fraction and E-wave deceleration time.
  
  
  CONCLUSIONS
  In spite of aggressive treatment, systolic ventricular dysfunction remains a frequent event after the anterior wall myocardial infarction. Additionally, 25% of patients show functional recovery. Finally, infarct size was the only significant predictor of functional recovery after six months of acute myocardial infarction.
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Minicucci
authors.forename: Elaine
authors.initials: E
authors.lastname: Farah
authors.forename: Daniéliso R
authors.initials: DR
authors.lastname: Fusco
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Cogni
authors.forename: Paula S
authors.initials: PS
authors.lastname: Azevedo
authors.forename: Katashi
authors.initials: K
authors.lastname: Okoshi
authors.forename: Silméia G
authors.initials: SG
authors.lastname: Zanati
authors.forename: Beatriz B
authors.initials: BB
authors.lastname: Matsubara
authors.forename: Sergio A R
authors.initials: SA
authors.lastname: Paiva
authors.forename: Leonardo A M
authors.initials: LA
authors.lastname: Zornoff
mesh_terms: D000368:Aged; D004452:Echocardiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology* / Q000534:rehabilitation*; D020127:Recovery of Function; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology* / Q000534:rehabilitation*