RESUMO
BACKGROUND: It is well established fact that acute coronary occlusion leads to diastolic dysfunction, followed by systolic dysfunction when myonecrosis occur. It is also proven that primary percutaneous coronary intervention (PPCI) is an excellent therapy for ST elevation myocardial infarction (STEMI) to improve outcomes. However there is a paucity of information on efficacy of PPCI in improving diastolic function. Evaluation of the role of PPCI in improving diastolic dysfunction is required. METHODS: 61 patients with first anterior wall STEMI who underwent PPCI to left anterior descending artery were included. Echocardiographic evaluation was performed within 24â¯h of PPCI and then on day 15, 3â¯months and 6â¯months after PPCI. We evaluated the prevalence of diastolic dysfunction after PPCI and its recovery during 6â¯months along with effect of duration of chest pain on diastolic function. RESULTS: 54.1% of patients had diastolic dysfunction after PPCI whereas it was only 21.3% after 6â¯months (p valueâ¯<â¯0.001). Diastolic function indices like deceleration time, isovolumic relaxation time, E wave, A wave, E/A ratio, left atrial volume and index improved statistically from baseline to 6â¯months except mitral E/e' ratio. As time required to achieve reperfusion increases (chest pain duration and D to B time) the incidence of residual diastolic dysfunction also increases (p valueâ¯<â¯0.001). Patients with TIMI flowâ¯<â¯III had more diastolic dysfunction (p valueâ¯<â¯0.001). CONCLUSIONS: Primary PCI improves diastolic dysfunction in patients with anterior wall STEMI over a period of 6â¯months. Time to achieve reperfusion and effectiveness of reperfusion have significant effect on diastolic dysfunction.