Infarct Size as Predictor of Systolic Functional Recovery after Myocardial Infarction

• Autor(a) principal: Minicucci, Marcos Ferreira [UNESP]
• Data de Publicação: 2014
• Outros Autores: Farah, Elaine [UNESP], Fusco, Danieliso R. [UNESP], Cogni, Ana Lucia [UNESP], Gaiolla, Paula Schmidt Azevedo [UNESP], Okoshi, Katashi [UNESP], Zanati, Silmeia G. [UNESP], Matsubara, Beatriz Bojikian [UNESP], Paiva, Sergio Alberto Rupp de [UNESP], Zornoff, Leonardo Antonio Mamede [UNESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.5935/abc.20140051; http://hdl.handle.net/11449/111166
• topic: Myocardial Infarction; Heart Failure; Ventricular Dysfunction; Recovery of Function

Background: The effects of modern therapy on functional recovery after acute myocardial infarction (AMI) are unknown.Objectives: To evaluate the predictors of systolic functional recovery after anterior AMI in patients undergoing modern therapy (reperfusion, aggressive platelet antiaggregant therapy, angiotensin-converting enzyme inhibitors and beta-blockers).Methods: A total of 94 consecutive patients with AMI with ST-segment elevation were enrolled. Echocardiograms were performed during the in-hospital phase and after 6 months. Systolic dysfunction was defined as ejection fraction value < 50%.Results: In the initial echocardiogram, 64% of patients had systolic dysfunction. Patients with ventricular dysfunction had greater infarct size, assessed by the measurement of total and isoenzyme MB creatine kinase enzymes, than patients without dysfunction. Additionally, 24.5% of patients that initially had systolic dysfunction showed recovery within 6 months after AMI. Patients who recovered ventricular function had smaller infarct sizes, but larger values of ejection fraction and E-wave deceleration time than patients without recovery. At the multivariate analysis, it can be observed that infarct size was the only independent predictor of functional recovery after 6 months of AMI when adjusted for age, gender, ejection fraction and E-wave deceleration time.Conclusion: In spite of aggressive treatment, systolic ventricular dysfunction remains a frequent event after the anterior myocardial infarction. Additionally, 25% of patients show functional recovery. Finally, infarct size was the only significant predictor of functional recovery after six months of acute myocardial infarction.