Left Ventricle Remodeling Clinical Trial
Official title:
Long Term Follow Up and Outcome of Left Ventricular Remodeling in ST Segment Myocardial Infarction Patients After Primary Percutaneous Coronary Intervention
- To detect long-term effects of left ventricular remodeling in STEMI patients undergoing
PPCI.
- And to evaluate outcome.
Acute myocardial infarction (AMI) with its accompanying adverse sequelae remains one of the
most common causes of morbidity and mortality in the world .
Reperfusion therapy is by far the most important therapy for the treatment of acute MI.
Reperfusion of the ischemic myocardium reduces the infarct size and improves left ventricular
function, both of which contribute to an improved clinical outcome in patients with acute MI
.
Using primary PCI has reduced the mortality of patients with acute MI . However, the
increased survival rate resulted in the increased incidence of cardio vascular events mainly
due to LV remodeling and congestive heart failure .
Post-infarct ventricular remodeling develops in about 30% of patients with a history of
myocardial infarction. Ventricular remodeling is a predictor of heart failure and for this
reason it assumes a negative prognostic value .
Left ventricular remodeling after ST-segment elevation myocardial infarction (STEMI) treated
with primary percutaneous coronary intervention is a major determinant for the short-term and
long-term clinical outcomes . Adverse left ventricular remodeling refers to alterations in
ventricular architecture involving both the infarcted and non-infarcted zones leading to
progressive increase in systolic and diastolic left ventricular volumes.
Left ventricular remodeling following a ST-segment elevated myocardial infarction (STEMI) is
an adaptive response to maintain the cardiac output despite myocardial tissue loss. Limited
studies have evaluated long term ventricular function after STEMI.
Left Ventricular remodeling, both positive and negative, is an ongoing process and continues
at least up to 2 years after STEMI, involving the infarct zone and remote zones. Long-term
left ventricular ejection fraction (LVEF) deterioration is characterized by an increase in
end-systolic volume and less wall thickening in the remote zones. Patients with long-term
LVEF improvement exhibit an increase in left ventricular wall thickening both in the
transmural infarct and remote zones. For elucidation of long term effects of left ventricular
remodeling, the current study is conducted.
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