Abstract
Objective: Few studies are available on the hemodynamic changes acutely determined by Primary Percutaneous Coronary Intervention (PCI) in ST-Elevation Myocardial Infarction (STEMI) patients, probably for the difficult evaluation of hemodynamic variables in this acute setting. Therefore, the paper is to evaluate the variations of several hemodynamic parameters determined by PCI using PRAM (Pressure Recording Analytical Method), minimally invasive hemodynamic monitoring. Methods: We analyzed in 20 STEMI patients submitted to PCI several hemodynamic variables, assessed with PRAM from radial/ femoral artery, 3-minute before PCI and at endprocedure. Variables measures were: systolic, diastolic, dicrotic and mean arterial pressures; heart rate (HR); stroke volume (SV); systemic vascular resistance (SVR); dP/dtmax; cardiac cycle efficiency (CCE). Results: In our patients HR, SVR and dP/dtmax decreased significantly (85 ± 6.3 to 77 ± 4.5, p = 0.002; 1738 ± 241 to 1450 ± 253, p = 0.022; 1.22 ± 0.11 to 1.11 ± 0.12, p = 0.007, respectively) while CCE and SV increased significantly (?0.25 ± 0.23 to ?0.01 ± 0.12, p
Highlights
IntroductionIn the last fifteen years Primary Percutaneous Coronary Intervention (PCI) has become a widespread treatment for ST-Elevation Myocardial Infarction (STEMI) patients and several studies have been performed on different aspects related to this procedure, few data are available about the hemodynamic changes that Primary PCI can acutely determine with the culprit artery re-opening
Primary Percutaneous Coronary Intervention (PCI) is considered the gold standard for the treatment of STElevation Myocardial Infarction (STEMI) because it is able to reduce short and long-term mortality and Major Adverse Cardiac Events at follow-up. in the last fifteen years Primary PCI has become a widespread treatment for ST-Elevation Myocardial Infarction (STEMI) patients and several studies have been performed on different aspects related to this procedure, few data are available about the hemodynamic changes that Primary PCI can acutely determine with the culprit artery re-opening
In the last fifteen years Primary PCI has become a widespread treatment for STEMI patients and several studies have been performed on different aspects related to this procedure, few data are available about the hemodynamic changes that Primary PCI can acutely determine with the culprit artery re-opening
Summary
In the last fifteen years Primary PCI has become a widespread treatment for STEMI patients and several studies have been performed on different aspects related to this procedure, few data are available about the hemodynamic changes that Primary PCI can acutely determine with the culprit artery re-opening. The minimally invasive hemodynamic monitoring systems, mainly based on the Pulse Contour Method, could be more suitable for the evaluation of the acute effects of Primary PCI. In this brief communication we report our preliminary experience, with one of these monitoring systems, PRAM (Pressure Recording Analytical Method) [5,6] used in 20 STEMI patients during primary PCI in OPEN ACCESS
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