Abstract
BackgroundTo evaluate the predictive value of the index of microcirculatory resistance (IMR) for long-term cardiac systolic function after primary percutaneous coronary intervention (pPCI) in patients with acute anterior wall ST-segment elevation myocardial infarction (STEMI).MethodsA total of 53 acute anterior wall STEMI patients were included and followed up within 1-year. IMR was measured to evaluate the immediate intraoperative reperfusion. IMR > 40 U was defined as the high IMR group and ≤ 40 U was defined as the low IMR group. Left ventricular ejection fraction (LVEF) was measured by echocardiography at 24 h, 1 month, 3 months, and 1 year after PCI to analyze the correlation between IMR and cardiac systolic function. Heart failure was estimated according to classification within one year.ResultsThe ratio of TMPG (TIMI myocardial perfusion grade) 3 (85.7% vs. 52%, p = 0.015) and STR (ST-segment resolution) > 70% (82.1% vs. 48%, p = 0.019) were significantly higher in the low IMR group. The LVEF in the low IMR group was significantly higher than that in the high IMR group at 3 months (43.06 ± 2.63% vs. 40.20 ± 2.67%, p < 0.001) and 1 year (44.16 ± 2.40% vs. 40.13 ± 3.48%, p < 0.001). IMR was negatively correlated with LVEF at 3 months (r = − 0.1014, p = 0.0040) and 1 year (r = − 0.1754, p < 0.0001).ConclusionsThe IMR showed significant negative correlation with the LVEF value after primary PCI. The high IMR is a strong predictor of heart failure within 1 year after anterior myocardial infarction.
Highlights
To evaluate the predictive value of the index of microcirculatory resistance (IMR) for long-term cardiac systolic function after primary percutaneous coronary intervention in patients with acute anterior wall ST-segment elevation myocardial infarction (STEMI)
Baseline clinical characteristics A total of 53 anterior wall STEMI patients who were followed up without any death for 1 year were included in the present analysis (Fig. 1)
Angiographic characteristics There was no difference in angiography parameters including Left anterior descending (LAD) occlusion, drug eluting stent (DES) and balloon dilation between the two groups, except for a significantly higher percentage of TMPG 3 (85.7% versus 52%, p = 0.015) and a higher STR > 70% ratio
Summary
To evaluate the predictive value of the index of microcirculatory resistance (IMR) for long-term cardiac systolic function after primary percutaneous coronary intervention (pPCI) in patients with acute anterior wall ST-segment elevation myocardial infarction (STEMI). Persistent microvascular dysfunction has been associated with worse long-term cardiac function [4].The current metric for quantifying microvascular injury post-STEMI is cardiac magnetic resonance imaging (CMR), which is not readily available during reperfusion in the catheterization laboratory [5]. In this regard, the index of microcirculatory resistance (IMR), an invasive physiological index and readily. The aim of this retrospective study with prospectively enrolled patients with acute anterior wall STEMI was to evaluate the predictive value of IMR for long-term cardiac systolic function after pPCI
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