Assessment of Left Ventricular Systolic Function After Acute Anterior Wall Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention at 24 Hours and 6 Weeks After the Procedure

Abstract

Background: Acute total occlusion of left anterior descending artery causes acute anterior wall myocardial infarction (AWMI) which could lead to left ventricular (LV) systolic dysfunction. Intervention by primary percutaneous coronary intervention (pPCI) can prevent severe LV systolic dysfunction by timely reperfusion of myocardium preventing irreversible damage. Objective: The aim of the study was to assess the LV systolic function by ejection fraction (EF) on transthoracic echocardiography (TTE) after pPCI in patients presenting with acute AWMI at 24 hours after procedure and 6 weeks follow-up. We also want to observe if duration of appearance of chest pain and time taken by patient to reach tertiary care hospital with pPCI setup has any link with the improvement of LV systolic function. Methods: The descriptive case series type of study conducted at Chaudhary Pervaiz Elahi Institute of Cardiology, Multan for one year. Patients with acute AWMI who were treated with pPCI were included in study. LV function was assessed by EF calculated by eye ball method on TTE at 24 hours and 6 weeks interval. Duration of chest pain was noted. Results: Total 68 patients were included in the study. Mean age of patients was 44.82 years with standard deviation of 9.06 years. 82.4% patients were male. 45.6% patients were presented between 2 to 6 hours of chest pain. Maximum improvement in EF at 6 weeks follow up was seen in patients who presented within 30 minutes and patients have regained full LV function. 11 patients who presented after 6 hours of chest pain had no improvement in EF at 6 weeks follow-up. Conclusion: Timely intervention by pPCI after acute AWMI can prevent LV systolic dysfunction.