Long-term recovery of left ventricular function after primary angioplasty for acute myocardial infarction

Aims To investigate changes: in left ventricular function in the first 6 mo nths after acute myocardial infarction treated with primary angioplasty. To assess clinical variables, associated with recovery of left ventricular fu nction after acute myocardial infarction. Methods Changes in left ventricular function were studied in 600 consecutiv e patients with acute myocardial infarction, all treated with primary angio plasty. Left ventricular ejection fraction was measured by radionuclide ven triculography in survivors at day 4 and after 6 months. Patients with a rec urrent myocardial infarction within the 6 months were excluded. Results Successful reperfusion (TIMI 3 flow) by primary angioplasty was ach ieved in 89% of patients. The mean ejection fraction at discharge was 43.7% , +/- 11.4, whereas the mean ejection fraction after 6 months was 46.3% +/- 11.5 (P<0.01). During the 6 months, the mean relative improvement in left ventricular ejection fraction was 6%,. An improvement in left ventricular f unction was observed in 48% of the patients: 25%, of the patients had a dec rease, whereas in the remaining patients there was no change. After univari ate and multivariate: analysis, an anterior infarction location, an ejectio n fraction at discharge <less than or equal to>40% and single-vessel diseas e were significant predictors of left ventricular improvement Juring the 6 months. Conclusions After acute myocardial infarction treated with primary angiopla sty there was a significant recovery of left ventricular function during th e first 6 months after the infarction. An anterior myocardial infarction, s ingle-vessel coronary artery disease, and an initially depressed left ventr icular function were independently associated with recovery of left ventric ular function. Multivessel disease was associated with absence of functiona l recovery. Additional studies, investigating complete revascularization ar e needed, as this approach may potentially improve long-term left ventricul ar function. (Eur Heart J 2001; 22: 785-790, doi:10.1053/euhj.2000.2316) (C ) 2001 The European Society of Cardiology.