Objectives. Quantitative assessment of the recovery of the regional and global left ventricular systolic function after reperfusion in acute myocardial infarction Background. Left ventricular systolic function is an important predictor of outcome after acute myocardial infarction.
Methods. The study included 60 patients with first time acute myocardial infarction, 30 were treated with fibrinolytic therapy (pharmacological subgroup), and 30 were treated with emergency percutaneous coronary intervention (invasive subgroup). Evaluation was performed at 1 week and after 30 days by conventional echo, tissue Doppler image, and 2dimentional strain (Global longitudinal peak systolic strain).
Results. 47% of the study populations were considered as having a significant recovery in systolic function by one month (60% of invasive subgroup, and 40% of those who had fibrinolysis, p=0.5). Conventional echo parameters showed insignificant difference neither from 1 week to 1month, nor between the two subgroups. There was significant improvement in systolic wave by tissue Doppler from 5cm/sec ±4 at 1 week to 7 cm/sec ±3 at one month, and was higher in invasive subgroup compared to pharmacological subgroup (8 cm/sec ±2 versus 5 cm/sec ±2, p= 0.02). Global longitudinal peak systolic strain showed significant improvement from -13.5% ±7 at one week to -15 % ±8 at one month. It was better in invasive group than in pharmacological one at baseline (-15.2%±5 versus -11.9%±4, p= 0.04). At one month, Global longitudinal peak systolic strain improved to -12%±4%, -16%±3 in the pharmacological and invasive subgroups respectively, p 0.04.
Conclusion. Global longitudinal peak systolic strain and Tissue Doppler parameters detected the recovery of left ventricular systolic function after myocardial infarction Moreover, better recovery was reported in invasive reperfusion than pharmacological one.