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Hyperoxemic perfusion of the left anterior descending coronary artery after primary angioplasty in anterior ST‐elevation myocardial infarction
Author(s) -
Trabattoni Daniela,
Bartorelli Antonio L.,
Fabbiocchi Franco,
Montorsi Piero,
Ravagnani Paolo,
Pepi Mauro,
Celeste Fabrizio,
Maltagliati Anna,
Marenzi Giancarlo,
O'Neill William W.
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20704
Subject(s) - medicine , cardiology , percutaneous coronary intervention , myocardial infarction , ejection fraction , angioplasty , artery , st segment , perfusion , ventricle , creatine kinase , heart failure
Objectives : To assess left ventricle function recovery, ST‐segment changes, and enzyme kinetic in ST‐elevation myocardial infarction patients treated with intracoronary hyperoxemic perfusion (IHP) after primary percutaneous coronary intervention and compare them with the results obtained in control patients.Background : IHP has been shown to attenuate microvascular reperfusion injury, which may result in poor LV function recovery despite successful primary percutaneous coronary intervention.Methods : Twenty seven anterior ST‐elevation myocardial infarction patients treated ≤12 hr after symptom onset by primary percutaneous coronary intervention were subjected to selective IHP into the left anterior descending coronary artery for 90 min. They were compared with 24 anterior ST‐elevation myocardial infarction control patients matched in clinical and angiographic characteristics and treated with conventional primary percutaneous coronary intervention. Left ventricular function recovery was evaluated by serial 2D contrast echocardiography.Results : Left anterior descending coronary artery recanalization was successful in all patients. After IHP (100% successful, duration 90 ± 5.4 min), patients showed a 4.8 ± 2.2 hr shorter time‐to‐peak creatine kinase release ( P = 0.001), a shorter creatine kinase half‐life period (23.4 ± 8.9 hr vs. 30.5 ± 5.8 hr, P = 0.006), and a higher rate of complete ST‐segment resolution (78% vs. 42%, P = 0.01). A significant improvement of mean left ventricular ejection fraction (from (44 ± 9)% to (55 ± 11)%, P < 0.001) and wall motion score index (from 1.77 ± 0.2 to 1.39 ± 0.4, P < 0.001) was observed at 3 months in IHP patients only.Conclusion : After successful primary coronary intervention, IHP is associated with significant left ventricular function recovery when compared to conventional treatment. Enzyme kinetic and ST‐segment changes suggest faster and more complete microvascular reperfusion and may explain the salutary effects of this new therapy on left ventricular function. © 2006 Wiley‐Liss., Inc.