IMPROVEMENT IN LV END-DIASTOLIC PRESSURE AFTER PRIMARY PCI AND ITS IMPACT ON PATIENTS’ RECOVERY

M ABUBAKAR; MAUR SAQI; S PERVEZ; JA SIAL; MW ASHRAF; M FAROOQ

doi:10.54112/bcsrj.v2024i1.1172

Authors

M ABUBAKAR Department of Cardiology ational Institute of Cardiovascular Diseases Karachi, Pakistan
MAUR SAQI Department of Cardiology ational Institute of Cardiovascular Diseases Karachi, Pakistan
S PERVEZ Department of Cardiology ational Institute of Cardiovascular Diseases Karachi, Pakistan
JA SIAL Department of Cardiology ational Institute of Cardiovascular Diseases Karachi, Pakistan
MW ASHRAF Department of Cardiology ational Institute of Cardiovascular Diseases Karachi, Pakistan
M FAROOQ Department of Cardiology ational Institute of Cardiovascular Diseases Karachi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1172

Keywords:

Left ventricular end-diastolic pressure, primary percutaneous coronary intervention, ST-segment elevation myocardial infarction, cardiac recovery, hemodynamic stability, myocardial infarction, patient outcomes, adjunctive therapies

Abstract

Left ventricular end-diastolic pressure (LVEDP) is a crucial indicator of cardiac function, particularly in patients with acute ST-segment elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) is the standard of care for STEMI, but its impact on LVEDP and patient recovery remains to be thoroughly studied. Objective: This study aimed to evaluate the improvement in LVEDP following primary PCI in patients with acute STEMI and to assess its impact on recovery and clinical outcomes. Methods: This prospective study included 100 patients with acute STEMI treated by primary PCI. LVEDP was recorded at four-time points: before PCI, and at one week, one month, and three months post-PCI. Demographic and clinical characteristics were also collected. Statistical analysis was performed to compare LVEDP values at different time intervals using paired t-tests and repeated measures ANOVA to assess significant changes over time. Results: The mean LVEDP significantly decreased from 18 ± 4 mmHg before PCI to 12 ± 3 mmHg at one week, 10 ± 2 mmHg at one month, and 9 ± 2 mmHg at three months post-PCI (p < 0.001). This demonstrated a consistent improvement in left ventricular function and hemodynamic status, suggesting favorable patient recovery post-intervention. Conclusion: Primary PCI significantly reduces LVEDP in patients with acute STEMI, leading to improved cardiac function and patient recovery. Monitoring LVEDP post-PCI can serve as a valuable predictor of patient prognosis and long-term outcomes. Further studies are warranted to explore additional therapies that may further enhance recovery and improve the quality of life in STEMI patients.

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References

- Batra, M.K., Malik, M.A., Khan, K.A., Rai, L., Kumar, R., Shah, J.A., Sial, J.A., Saghir, T., Khan, N. and Karim, M., 2022. Left ventricular functional remodeling after primary percutaneous coronary intervention. Journal of Cardiovascular Echography, 32(1), pp.12-16.

- Hanson, L., Vogrin, S., Noaman, S., Goh, C.Y., Zheng, W., Wexler, N., Jumaah, H., Al-Mukhtar, O., Bloom, J., Haji, K. and Schneider, D., 2023. Left ventricular end-diastolic pressure for the prediction of contrast-induced nephropathy and clinical outcomes in patients with ST-elevation myocardial infarction who underwent primary percutaneous intervention (the ELEVATE Study). The American Journal of Cardiology, 203, pp.219-225.

- van der Bijl, P., Abou, R., Goedemans, L., Gersh, B.J., Holmes Jr, D.R., Ajmone Marsan, N., Delgado, V. and Bax, J.J., 2020. Left ventricular post-infarct remodeling: implications for systolic function improvement and outcomes in the modern era. Heart Failure, 8(2), pp.131-140.

- Yi, L., Zhu, T., Qu, X., Buayiximu, K., Feng, S., Zhu, Z., Ni, J., Du, R., Zhu, J., Wang, X. and Ding, F., 2024. Predictive value of early left ventricular end-diastolic volume changes for late left ventricular remodeling after ST-elevation myocardial infarction. Cardiology Journal, 31(3), pp.451-460.

- Zhou, X., Lei, M., Zhou, D., Li, G., Duan, Z., Zhou, S. and Jin, Y., 2020. Clinical factors affecting left ventricular end-diastolic pressure in patients with acute ST-segment elevation myocardial infarction. Annals of Palliative Medicine, 9(4), pp.1834840-1831840.

- Liu, C., Caughey, M.C., Smith Jr, S.C. and Dai, X., 2020. Elevated left ventricular end diastolic pressure is associated with increased risk of contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention. International Journal of Cardiology, 306, pp.196-202.

- Xu, Y., Zhang, W., Zhong, X., Yan, S., Chen, H., Guo, R., Luo, X. and Liu, Q., 2021. Effect of early use of ivabradine on left ventricular remodeling after primary percutaneous coronary intervention in patients with acute ST‐segment elevation myocardial infarction: A pilot test. Annals of Noninvasive Electrocardiology, 26(2), p.e12816.

- Fattah Fahmy, A.G.A. and L Bordy, M.E., 2021. Predictors of left ventricular systolic dysfunction after primary percutaneous coronary intervention for patients with left anterior descending artery occlusion. Journal of Medicine in Scientific Research, 4(4), p.5.

- Liu, Y., Sun, Y. and Dai, W., 2024. Effect of sacubitril–valsartan on left ventricular remodeling in patients with acute myocardial infarction after primary percutaneous coronary intervention: a systematic review and meta-analysis. Frontiers in Pharmacology, 15, p.1366035.

- Ren, F., Xue, T., Tang, G., Zhang, M., Zhao, J., Chen, Y.A., Fan, J., Yu, M. and Zhang, J., 2022. Assessment of myocardial work of the left ventricle before and after PCI in patients with non‐ST‐segment elevation acute coronary syndrome by pressure‐strain Loop technology. Computational and Mathematical Methods in Medicine, 2022(1), p.8026689.

- Dong, Y., Xu, Y., Ding, C., Yu, Z., Yu, Z., Xia, X., Chen, Y. and Jiang, X., 2022. Comparing the efficacy of angiotensin receptor-neprilysin inhibitor and enalapril in acute anterior STEMI patients after primary percutaneous coronary intervention: a prospective randomized trial. Cardiovascular Diagnosis and Therapy, 12(1), p.42.

- Khaled, S. and Shalaby, G., 2022. Myocardial recovery after percutaneous coronary intervention in coronary artery disease patients with impaired systolic function-predictive utility of global longitudinal strain. Indian Heart Journal, 74(6), pp.488-493.