Coronary flow grade is independent predictor of improved left ventricularfunction in patients with acute myocardial infarction treated by primary PCI: a two-dimensional speckle tracking study / Монголын Анагаах Ухаан

ABSTRACT

Introduction Coronary TIMI flow gradewas previously demonstrated to be related to outcome after acute myocardial infarction. However, the relationship between coronary flow grade and left ventricular global longitudinal strainin patients with acute myocardial infarction (AMI) treated by primary percutaneous intervention (PCI) were unclear. Goal In this study, we aimed to reveal the relationship between coronary TIMI flow grade and LV GLS in patients with AMI. Materials and Methods We prospectively selected patients with AMI who treated by primary PCI. Based on whether TIMI 3 flow achieved at the end of the procedure patients were divided into two groups. Group I (TIMI 3 flow was achieved, n=367), Group II (TIMI 3 flow was not achieved, n=47). The LV GLS was assessed by 2dimensional speckle-tracking echocardiography (2D STE). Results A total of 413 patients (mean age 60±13, 84% male) were included and TIMI 3 flow was achieved in 367 patients (88%). LV GLS was significantly impaired in patients who had TIMI 3 flow not achieved compared with TIMI 3 flow achieved group (-13.1±4.8% vs. -15.3±3.8%, p<0.001). Multiple linear regression analysis which included age, gender, clinical, biochemical and angiographic variables showed that coronary TIMI flow grade of culprit artery was independently associated with LV GLS. There was negative correlation between coronary TIMI flow grade and LV GLS (Pearson’s r=-0.183, p<0.001). Simple linear regression analysis revealed that coronary TIMI flow grade is directly associated with LV GLS (β=-1.61, p<0.001) and which indicated that every 1 scale increase of final coronary TIMI flow grade resulted -1.61% increase of LV GLS. Conclusion Our study demonstrated the coronary TIMI flow grade of the culprit artery was independently associated with LV GLSin patients with AMI treated by primary PCI.