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Volume 51, Issue 1, 2015

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Articles

Medicina (Kaunas) 2015; 51 (1): 38-45
DOI: 10.1016/j.medici.2015.01.005

Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease.

Edvardas Vaicekavičius 1
Donatas Vasiliauskas 1
Ramūnas Navickas 1
Irena Milvidaitė 1
Ramūnas Unikas 2
Jonė Venclovienė 1
Raimondas Kubilius 2
1 Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
2 Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
Keywords
Left ventricular function
Multivessel coronary artery disease
Postreperfusion left ventricle recovery
Primary percutaneous coronary intervention

The aim of this study was to investigate the impact of admission systolic blood pressure (ASBP) and left ventricular (LV) mass on the postreperfusion LV recovery in patients with ST-segment elevation myocardial infarction (STEMI) and concomitant coronary multivessel disease (MVD).
A retrospective analysis of 12-month postreperfusion LV recovery was performed in 104 patients after primary percutaneous coronary intervention (PPCI). Patients with elevated ASBP (>140mmHg) were assigned to the first group (n=58); with normal ASBP (<140mmHg), to the second group (n=46); with increased myocardial mass index (MMI) (>100g/m(2)), to the third group (n=70); and with normal MMI (<100g/m(2)), to the fourth group (n=34). Severity of MVD was evaluated by the Syntax score. The LV recovery was assessed by evolution of quantitative characteristics of electrocardiography (QRS score, ST score, ECG STEMI stage) and echocardiography (LV ejection fraction, volume and mass indices) registered before and after PPCI, at discharge, and after 1, 6, and 12 months.
There were no significant differences in the baseline QRS and ST scores, ECG STEMI stage, LVEF, MMI, and Syntax score comparing all the patients’ groups. The serial ECG criteria showed only a very small impact of ASBP on postreperfusion LV recovery. Only ECG STEMI stage progression was slower in the patients with elevated ASBP. In patients with different MMI, the QRS and ST scores were higher and ECG STEMI stage was lower in patients with increased MMI. LVEF after 1 year was significantly lower in the third group as compared to the fourth group (42.58%±8.25% vs. 46.8%±7.13%, P=0.018).
Postreperfusion LV recovery was more related not to ASBP but to the increased LV mass assessed by echocardiography in patients with STEMI and MVD.

Correspondence to R. Kubilius Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50161 Kaunas, Lithuania. raimondas@efarmacija.lt

Received 28 October 2013, accepted 16 January 2015, available online 28 January 2015.

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Medicina is a peer-reviewed monthly scientific journal of Lithuanian Medical Association, Lithuanian University of Health Sciences and Vilnius University

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