Relationship between Left Ventricular Diastolic Function and Time to Reperfusion by Primary Percutaneous Coronary Intervention in ST Segment Elevation Myocardial Infarction Patients

Abstract

Background: The therapy and prognosis of acute myocardial infarction (MI) have been modified by primary percutaneous coronary intervention (PPCI). Delayed time to reperfusion in STEMI patients is risk predictor fo left ventricular diastolic dysfunction and linked to increase risk of heart failure. AMI-associated adverse remodeling, a higher possibility of heart failure, and reduced survival are all linked to echocardiographic indicators of diastolic dysfunction. Aims: The aim of this study was to determine the relationship between left ventricular diastolic functioning and time-to-reperfusion by PPCI for individuals with STEMI. Patients and Methods: The current study included 50 patients admitted with STEMI & underwent primary PCI in Cardiology Department in Tanta University Hospitals. They were divided into two groups: Group 1 early reperfusion (<6h) and group 2 delayed reperfusion (>6h). They presented by chest pain within 24 hours and conducted echocardiography within 72-hours of PPCI. Results:  The median time-to-reperfusion, which is the time from the onset of symptoms to reperfusion at the end of PPCI, was 240 minutes (interquartile range: 120-720 minutes). LV ejection fraction and E/septal e' did not vary significantly between both groups.  The current research found that those with delayed time to reprfusion were troponin (+), CKMB (+), CRP (+), high LVDd, high E/e` average, high LA volume, high LA volume index and had high grade diastolic dysfunction compared to patients with early time to reperfusion. This study showed that group ІІ was significantly higher than group І   regarding to time to reperfusion & diastolic dysfunction. Conclusion: In PPCI-treated individuals who have STEMI, earlier increased LV diastolic pressure is linked to a longer time-to-reperfusion. We also found that creatine kinase, troponin and CRP were significantly higher in the late reperfusion group compared to early reperfusion group. Time to reperfusion and CRP were significantly associated with LVDD grade. CK, LVDs, LVDd, e´ Lateral, E/e´ Lateral, E/e´ average, LA volume index and Diastolic dysfunction grade were identified as independent predictors for LVDD.