PMID- 30073720
OWN - NLM
STAT- MEDLINE
DCOM- 20190219
LR  - 20190320
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 35
IP  - 10
DP  - 2018 Oct
TI  - Predictors of myocardial functional recovery following successful reperfusion of 
      acute ST elevation myocardial infarction.
PG  - 1571-1578
LID - 10.1111/echo.14106 [doi]
AB  - BACKGROUND: Following acute ST elevation myocardial infarction (STEMI), 
      restoration of large-vessel patency does not mean complete perfusion recovery. 
      Little is known regarding the predictors of successful myocardial reperfusion for 
      the STEMI patients undergoing pharmacologic and mechanical reperfusion 
      strategies. AIM OF THE WORK: The aim of this clinical study was to find out the 
      predictors of myocardial functional recovery following reperfusion of acute 
      STEMI, represented by 3-month global longitudinal strain (GLS) value assessed by 
      speckle tracking echocardiography. MATERIAL/METHODS: The study population 
      included 400 patients presented with first acute STEMI with successful 
      reperfusion by thrombolysis (group I) or primary percutaneous coronary 
      intervention (PPCI) (group II). Electrocardiography (ECG) at baseline and 
      90 minutes after coronary reperfusion was performed with assessment of ST 
      resolution. Basal and 3-month follow-up echocardiography was performed with 
      assessment of ejection fraction (EF), myocardial performance index (MPI), 
      systolic myocardial excursion (S'), and GLS. RESULTS: There was nonsignificant 
      difference between patients of both groups regarding age (P = 0.422) and gender 
      (P = 0.272). Also, there was a nonsignificant difference between both groups 
      regarding the risk factors of coronary artery disease like hypertension 
      (P = 0.511), diabetes mellitus (P = 0.332), and smoking (P = 0.381). But there 
      was significant statistical difference between both groups regarding dyslipidemia 
      (P = 0.012). Ninety-minute ST resolution was significantly higher in PPCI group 
      (P = 0.042). Moreover, PPCI group had significant improvement of EF (P = 0.013) 
      during follow-up, and highly significant improvement of MPI, S' and GLS 
      (P < 0.001) compared to the basal echocardiographic study. The percentage of 
      change (∆) of each of the echocardiographic parameter was compared between both 
      groups and revealed statistically significant improvement regarding EF, highly 
      significant improvement of MPI, S' and GLS in favor of PPCI arm (group II). 
      Multivariate regression analysis demonstrated that pain to reperfusion time, MI 
      territory, ST resolution, and basal GLS value are the most important predictors 
      for LV functional recovery. CONCLUSION: The study found pain to reperfusion time, 
      MI territory, ST resolution, basal GLS value are the most important predictors of 
      myocardial functional recovery. Regular follow-up with echocardiography for STEMI 
      patients with different reperfusion strategies has informative impact on 
      long-term clinical outcome. Also the study confirmed that PPCI is better than 
      thrombolysis not only in restoring epicardial coronary flow but also in restoring 
      microvascular and tissue perfusion assuring better myocardial functional recovery 
      and better long-term clinical outcomes.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Shehata, Islam ElSayed
AU  - Shehata IE
AD  - Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, 
      Egypt.
FAU - Cheng, Cheng-I
AU  - Cheng CI
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital, Kaohsiung City, Taiwan.
FAU - Sung, Pei-Hsun
AU  - Sung PH
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital, Kaohsiung City, Taiwan.
FAU - Ammar, Ahmed S
AU  - Ammar AS
AD  - Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, 
      Egypt.
FAU - El-Sherbiny, Islam Abd El-Moneem
AU  - El-Sherbiny IAE
AD  - Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, 
      Egypt.
FAU - Ghanem, Islam Ghanem Ahmed
AU  - Ghanem IGA
AD  - Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, 
      Egypt.
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital, Kaohsiung City, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20180802
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
SB  - IM
MH  - Acute Disease
MH  - Echocardiography/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart/diagnostic imaging/*physiology
MH  - Humans
MH  - Male
MH  - Mechanical Thrombolysis/*methods
MH  - Middle Aged
MH  - Myocardial Reperfusion/*methods
MH  - Percutaneous Coronary Intervention/*methods
MH  - Recovery of Function/*physiology
MH  - ST Elevation Myocardial Infarction/*therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - ST elevation myocardial infarction
OT  - ST resolution
OT  - global longitudinal strain
OT  - myocardial functional recovery
OT  - successful reperfusion
EDAT- 2018/08/04 06:00
MHDA- 2019/03/21 06:00
CRDT- 2018/08/04 06:00
PHST- 2018/06/01 00:00 [received]
PHST- 2018/07/03 00:00 [accepted]
PHST- 2018/08/04 06:00 [pubmed]
PHST- 2019/03/21 06:00 [medline]
PHST- 2018/08/04 06:00 [entrez]
AID - 10.1111/echo.14106 [doi]
PST - ppublish
SO  - Echocardiography. 2018 Oct;35(10):1571-1578. doi: 10.1111/echo.14106. Epub 2018 
      Aug 2.