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European Heart Journal 2001 22(9):785-790; doi:10.1053/euhj.2000.2316
Copyright © 2001 by the European Society of Cardiology.
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Long-term recovery of left ventricular function after primary angioplasty for acute myocardial infarction

J.P Ottervangera, A.W.J Van't Hofa, S Reiffersb, J.C.A Hoorntjea, H Suryapranataa, M.J de Boera and F Zijlstraa,f1

a Department of Cardiology, Isala Klinieken, Hospital de Weezenlanden, Zwolle, The Netherlands
b Department of Nuclear Medicine, Isala Klinieken, Hospital de Weezenlanden, Zwolle, The Netherlands

revised June 10, 2000; accepted June 21, 2000

Abstract

Aims To investigate changes in left ventricular function in the first 6 months after acute myocardial infarction treated with primary angioplasty. To assess clinical variables, associated with recovery of left ventricular function after acute myocardial infarction.

Methods Changes in left ventricular function were studied in 600 consecutive patients with acute myocardial infarction, all treated with primary angioplasty. Left ventricular ejection fraction was measured by radionuclide ventriculography in survivors at day 4 and after 6 months. Patients with a recurrent myocardial infarction within the 6 months were excluded.

Results Successful reperfusion (TIMI 3 flow) by primary angioplasty was achieved in 89% of patients. The mean ejection fraction at discharge was 43·7%±11·4, whereas the mean ejection fraction after 6 months was 46·3%±11·5 (P<0·01). During the 6 months, the mean relative improvement in left ventricular ejection fraction was 6%. An improvement in left ventricular function was observed in 48% of the patients; 25% of the patients had a decrease, whereas in the remaining patients there was no change. After univariate and multivariate analysis, an anterior infarction location, an ejection fraction at discharge ≤40% and single-vessel disease were significant predictors of left ventricular improvement during the 6 months.

Conclusions After acute myocardial infarction treated with primary angioplasty there was a significant recovery of left ventricular function during the first 6 months after the infarction. An anterior myocardial infarction, single-vessel coronary artery disease, and an initially depressed left ventricular function were independently associated with recovery of left ventricular function. Multivessel disease was associated with absence of functional recovery. Additional studies, investigating complete revascularization are needed, as this approach may potentially improve long-term left ventricular function.

Key Words: Acute myocardial infarction, primary angioplasty, left ventricular ejection fraction, stunning

f1 Correspondence: Dr Felix Zijlstra, Department of Cardiology, Isala Klinieken–Hospital de Weezenlanden, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.

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