title: Repeated echocardiography after first ever ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention--is it necessary?
abstract: OBJECTIVE
  Changes in left ventricular (LV) function using echocardiography and cardiac magnetic resonance (CMR) imaging were assessed in a contemporary ST-segment elevation myocardial infarction (STEMI) population to assess whether repeated imaging is necessary.
  
  
  METHODS
  In a prospective study patients with first STEMI were treated with primary percutaneous coronary intervention (PCI) and examined with 2D-echocardiography and CMR at baseline (<72 h) and at a three-month follow-up.
  
  
  RESULTS
  A total of 138 patients were included (60±11 years). Using 2D-echocardiography at baseline preserved left ventricular ejection fraction (LVEF) (>50%) was found in 48 patients (35%), mild/moderate systolic dysfunction (35-50%) in 76 patients (55%) and severe dysfunction (<35%) in 14 patients (10%). Improvement in systolic function group was seen in 58 patients (64%) and 11 patients (79%) with severe systolic dysfunction at baseline were re-classified as having preserved or mild/moderate systolic dysfunction at follow-up. Irrespective of baseline LVEF, deterioration in systolic function group was noted in 14 patients (11%), but no patients declined from preserved to severe systolic dysfunction. The recovered myocardium measured with the myocardial salvage index by CMR was significantly lower with declining LVEF at baseline.
  
  
  CONCLUSIONS
  The majority of patients with severely depressed LVEF immediately after STEMI significantly improved systolic function after three months. This study emphasises the importance of a repeated LV function assessment at follow-up in patients with mild/moderate or severe systolic dysfunction after STEMI, but re-assessment may not be needed in patients with preserved LVEF at baseline.
authors.affiliation: Department of Cardiology 2142, Copenhagen University Hospital Rigshospitalet, Denmark helle.soholm@gmail.com.
authors.forename: Helle
authors.initials: H
authors.lastname: Søholm
authors.affiliation: Department of Cardiology 2142, Copenhagen University Hospital Rigshospitalet, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Lønborg
authors.affiliation: Department of Cardiology 2142, Copenhagen University Hospital Rigshospitalet, Denmark.
authors.forename: Mads J
authors.initials: MJ
authors.lastname: Andersen
authors.affiliation: Department of Cardiology 2142, Copenhagen University Hospital Rigshospitalet, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Vejlstrup
authors.affiliation: Department of Cardiology 2142, Copenhagen University Hospital Rigshospitalet, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Jacob E
authors.initials: JE
authors.lastname: Møller
authors.affiliation: Department of Cardiology 2142, Copenhagen University Hospital Rigshospitalet, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Hassager
mesh_terms: D004452:Echocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011446:Prospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000000981:diagnostic imaging; D016277:Ventricular Function, Left
keywords: Left ventricular function; acute myocardial infarction; cardiac imaging; cardiac magnetic resonance imaging; echocardiography; heart failure; left ventricular ejection fraction