Original research

Early and late post-myocardial infarction left ventricular remodeling in patients after successful endovascular recanalization of infarction-related artery

L.M. Babii, N.P. Stroganova, Yu.O. Khomenko 

National Scientific Center «M.D. Strazhesko Institute of Cardiology NAMS of Ukraine», Kyiv, Ukraine 

The aim – to study the particular features of left ventricular (LV) remodeling in patients after successful endovascular recanalization of infarction-related artery in the early period of myocardial infarction (MI) and in the late post-MI period.
Materials and methods. We enrolled 94 patients surviving after Q-wave MI, where the successful endovascular recanalization of infarction-related artery was provided during 4–12 hours after MI onset. The first group (n = 39) included patients in the early period of MI; the second group (n = 55) included patients that survived 2 years after MI. Several echo parameters were determined: contractility function index (CFI) – stroke volume (SV) to end-systolic volume (ESV) ratio; residual myocardial reserve index (RMRI) – ESV to end-diastolic volume (EDV) index ratio. The control 1000 m walking test was provided in all patients with acute MI at the end of rehabilitation treatment period. The 6-minute walking test and NYHA functional class were studied in patients of these second group 2 years after MI.
Results. There were established several types of post-MI period course in 2 years after MI: 1) favorable – preserved LV systolic function, mild changes of the heart hemodynamics, values of CFI and RMRI, NYHA I class according to 6-minute walking test; 2) relatively favorable – preserved LV systolic function, moderate post-MI LV dilation, compensatory LV hypertrophy, NYHA I class according to 6-minute walking test (reduction of CFI and significant RMRI increasing were observed in some patients); 3) unfavorable – reduced LV systolic function, significant EDV and ESV increasing, severe changes of CFI and RMRI.
Conclusions. Several types of post-MI period course were established. Among them there was a type, which involved patients with high risk of unfavorable disease course.
Key words: myocardial infarction, left ventricle, myocardial remodeling, interventional treatment.