ISSN 1301 - 0883 / E-ISSN 1309 - 3886
 
 








  Acute Change of Left Ventricular End-diastolic Pressure during Primary Percutaneous Coronary Intervention and Its Relationship with Early Reperfusion Parameters [Eastern J Med]
Eastern J Med. 2020; 25(2): 250-255 | DOI: 10.5505/ejm.2020.60252  

Acute Change of Left Ventricular End-diastolic Pressure during Primary Percutaneous Coronary Intervention and Its Relationship with Early Reperfusion Parameters

Murat Cap1, Emrah ERDOĞAN2, Ali Karagöz3, Cem Doğan3, Rezzan Deniz Acar3, Tuba Unkun3, Çetin Geçmen3, Flora Özkalaycı4, Büşra Güvendi Şengör3, Zübeyde Bayram3, Cihangir Kaymaz3, NIHAL OZDEMIR3
1Department of Cardiology, SBU Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
2Department of Cardiology,Yuzuncu Yil University,Faculty of Medicine Van, Turkey
3Department of Cardiology, SBU Kartal Kosuyolu Traning and Research Hospital
4Department of Cardiology, Hisar İntercontinental Hospital, İstanbul,Turkey

INTRODUCTION: 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).
METHODS: 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.
RESULTS: 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).
DISCUSSION AND CONCLUSION: 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.

Keywords: Left ventricular end-diastolic pressure, ST-segment elevation myocardial infarction, Myocardial blush grade, ST-segment resolution


Murat Cap, Emrah ERDOĞAN, Ali Karagöz, Cem Doğan, Rezzan Deniz Acar, Tuba Unkun, Çetin Geçmen, Flora Özkalaycı, Büşra Güvendi Şengör, Zübeyde Bayram, Cihangir Kaymaz, NIHAL OZDEMIR. Acute Change of Left Ventricular End-diastolic Pressure during Primary Percutaneous Coronary Intervention and Its Relationship with Early Reperfusion Parameters. Eastern J Med. 2020; 25(2): 250-255

Corresponding Author: Murat Cap, Türkiye


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