Effect of different myocardial perfusion on cardiac function and left ventricular remodeling in patients with acute myocardial infarction after primary percutaneous coronary intervention

AIM:To investigate the effect of different myocardial perfusion on cardiac function and left ventricular remodeling in acute myocardial infarction (AMI) patients with TIMI III after percutaneous coronary intervention (PCI). METHODS: Intravenous myocardial contrast echocardiography (MCE) and two-dimensional echocardiographic examination were performed in 36 patients. Myocardial contrast echocardiography score (MCS) and wall motion score (WMS) were assessed to evaluate the relationship between myocardial perfusion and ventricular segmental wall motion. Patients were divided into group A and group B according to the results of contrast score indexes (CSI). Left ventricular ejection fraction (LVEF) in all patients was measured to evaluate the effect of myocardial perfusion on cardiac function. Left ventricular end-diastolic diameter (LVEDD) and LVEF in all patients were measured 6 months after PCI to further evaluate the effect of myocardial perfusion on left ventricular remodeling. RESULTS: All infarct-related arteries were TIMI III after PCI and 152 myocardial segments were relative to the reperfusion of infarct-related arteries. Among the 18 myocardial segments with MCS as 0, 2 (11.1%) had WMS of 1-2. Among the 30 myocardial segments with MCS as 0.5, 16 (53.3%) had WMS of 1-2 and among the 104 myocardial segments with MCS as 1, 82 (78.8%) had WMS of 1-2. Statistical analysis showed that the level of myocardial perfusion was positively related to the ventricular segmental wall motion (P<0.05). The average LVEF in group A was significantly higher than in group B ［(52.1±3.4)% vs.(47.2±2.9)%, P<0.05］. Six months after PCI, the average LVEF and LVEDD did not change significantly in group A, whereas average LVEF decreased ［(47.2±2.9)% vs.(43.8±4.4)%, P<0.05］ and the average LVEDD ［(50.2±2.9) mm vs.(56.3±3.1) mm, P<0.05］ increased in group B. CONCLUSION: The level of myocardial perfusion is to some degree associated with cardiac function and ventricular remodeling. Myocardial perfusion could, to some extent, restrain ventricular remodeling.