The association of left ventricular end-diastolic pressure and acute left ventricular end-diastolic pressure change with miyocardial blush grade and ST segment resolution in STEMI patients undergoing primary percutaneous intervention
Eastern Journal of Medicine, cilt.25, sa.2, ss.250-255, 2020 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 25 Sayı: 2
- Basım Tarihi: 2020
- Doi Numarası: 10.5505/ejm.2020.60252
- Dergi Adı: Eastern Journal of Medicine
- Derginin Tarandığı İndeksler: Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, Veterinary Science Database, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.250-255
- Anahtar Kelimeler: Left ventricular end-diastolic pressure, Myocardial blush grade, ST-segment elevation myocardial infarction, ST-segment resolution
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Elevated left ventricular end-diastolic pressure (LVEDP) is associated with adverse outcomes among those patients with ST-elevation myocardial infarction (STEMI).We aim to investigate the acute change of LVEDP in patients with STEMI and the relationship between LVEDP and early reperfusion parameters, such as ST-segment resolution (STR%) and myocardial blush grade (MBG). A total of 51 consecutive patients with STEMI who had undergone successful primary percutaneous coronary intervention (pPCI) with TIMI flow grade 3 were included in the study. LVEDP measurements were performed at the beginning (pre-pPCI LVEDP) and end of (post-pPCI LVEDP) the pPCI. MBG was defined after a successful pPCI; STR% was calculated 60 minutes after pPCI. The mean pre-pPCI LVEDP was 22.1 ± 4.8 mmHg and the post-pPCI LVEDP was 19.4 ± 4.8 mmHg. There was a mean 2.7±1.8 mmHg decrease in LVEDP values after pPCI which was statistically significant (95% CI -3.2, -2.2, p value< 0.001). Post-pPCI LVEDP median value was 19 mmHg. The patients were divided into two groups according to median value: There were 26 (51%) patients with post-pPCI LVEDP≤ 19 mmHg and 25 (49%) patients with post-pPCI LVEDP> 19 mmHg. STR% and MBG were significantly different between the two groups (p= 0.03 and p= 0.01). Post-pPCI LVEDP had a moderate negative correlation with MBG (r= -0.438) and STR% (r= -0.501). In this study, we demonstrated that primary PCI might substantially reduce the LVEDP level. Moreover, the LVEDP levels achieved after PCI might be associated with myocardial reperfusion, assessed by STR% on ECG and MBG during angiography.