Diastolic dysfunction of the left ventricular in patients with acute myocardial infarction with ST segment elevation after primary coronary artery stenting in the hospital period

Abstract

Objective — to establish the predictive effect of primary coronary artery stenting (PCI) on the clinical course and features of left ventricular (LV) remodelling in patients with acute myocardial infarction with ST segment elevation (STEMI) and diastolic dysfunction (DD) in the hospital period.
Materials and methods. The study included 80 patients with STEMI, who had undergone PCI (Group I), and 20 patients with STEMI without PCI (Group II). During the hospital period, the coronary angiography data were analyzed, the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and echocardiography parameters DD were determined in the 5th day. At the time of discharge veloergometry was performed to determine the angina pectoris patients, and the quality of life of patients evaluated on the Seattle Angina Questionnaire (SAQ).
Results. The mean NT-proBNP level in Group II was (782.3 ± 17.3) pg/ml, and in Group I — (300.5 ± 14.3) pg/ml (p < 0.001), which reliably points to less pronounced early LV remodelling processes in patients with STEMI. Indicators of DD were characterized by the ratio of early diastolic filling to late: in Group I — 0.89 ± 0.06, which is characteristic for DD with violation of relaxation processes of LV, and in Group II — 1.17 ± 0.04, which is typical of the restrictive type. According to SAQ, patients in Group I had better quality of life and higher physical activity tolerance at the level of I–II functional class determined in comparison with patients in Group II.
Conclusions. Patients with STEMI after performed PCI have significantly lower rates of NT-proBNP, which is an early marker of LV remodelling, as well as echocardiography parameters DD have less pronounced pathological character, increased exercise tolerance during hospitalization and better quality of life.