title: Doppler echocardiographic myocardial stunning index predicts recovery of left ventricular systolic function after primary percutaneous coronary intervention.
abstract: BACKGROUND
  Myocardial stunning is responsible for partially reversible left ventricular (LV) systolic dysfunction after successful primary percutaneous coronary intervention (PPCI) in patients with acute ST-elevation myocardial infarction (STEMI).
  
  
  OBJECTIVE
  To test the hypothesis that early coronary blood flow (CBF) to LV systolic function ratios, as an equivalent to LV stunning index (SI), predict recovery of LV systolic function after PPCI in patients with acute STEMI.
  
  
  METHODS
  Twenty-four patients with acute anterior STEMI who had successful PPCI were evaluated and compared to 96 control subjects. Transthoracic echocardiography with measurement of LV ejection fraction (EF), LV, and left anterior descending (LAD) coronary artery area wall-motion score index (WMSI) as well as Doppler sampling of LAD blood velocities, early after PPCI and 5 days later, were performed. SI was evaluated as the early ratio of CBF parameters in the LAD to LV systolic function parameters.
  
  
  RESULTS
  Early SI-LVEF well predicted late LVEF (r=.51, P<.01) and the change in LVEF (r=.48, P<.017). Early SI-LVMSI predicted well late LVEF (r=.56, P<.006) and the change in LVEF (r=.46, P<.028). Early SI-LADWMSI predicted late LVEF (r=.44, P<.028). Other SI indices measured as other LAD-CBF to LV systolic function parameters were not predictive of late LV systolic function.
  
  
  CONCLUSIONS
  LV stunning indices measured as early LAD flow to LVEF, LVWMSI, and LADWMSI ratios well predicted late LVEF and the change in LVEF. Thus, greater early coronary artery flow to LV systolic function parameter ratios predict a better improvement in late LV systolic function after PPCI.
authors.affiliation: Cardiology Department, Bnai Zion Medical Center, Haifa, Israel. dawod.sharif@b-zion.org.il.|Technion, Israel Institute of Technology, Haifa, Israel. dawod.sharif@b-zion.org.il.
authors.forename: Dawod
authors.initials: D
authors.lastname: Sharif
authors.affiliation: Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Wisam
authors.initials: W
authors.lastname: Matanis
authors.affiliation: Technion, Israel Institute of Technology, Haifa, Israel.|Department of Mathematics, The Academic Arab College, Haifa, Israel.
authors.forename: Amal
authors.initials: A
authors.lastname: Sharif-Rasslan
authors.affiliation: Cardiology Department, Bnai Zion Medical Center, Haifa, Israel.|Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Rosenschein
mesh_terms: D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000209:etiology; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*; D020257:Ventricular Remodeling
keywords: 
  STEMI
  ; left ventricular systolic function; myocardial stunning index; primary coronary angioplasty