[Ischemic postconditioning improves longitudinal contractile function of the reperfused myocardium in patients with anterior wall acute myocardial infarction]

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 Dec 28;44(12):1397-1405. doi: 10.11817/j.issn.1672-7347.2019.180495.
[Article in Chinese]

Abstract

To investigate whether ischemic postconditioning (IPTC) can promote the recovery of left ventricular impaired regional or global longitudinal systolic function. Methods: The trial was divided into a percutaneous coronary intervention (PCI) group, an PCI+IPTC group and a control group. Thirty-two patients with anterior acute anterior wall ST-segment elevation myocardial infarction (STEMI) underwent the first emergency PCI in the PCI group, 28 patients with anterior acute STEMI underwent the combination of PCI and IPTC in the PCI+IPTC group, while 30 patients underwent coronary angiography in the control group. Two-dimensional dynamic echocardiography was collected before operation, 0.5 h, 1 day, 3 days, 1 week, 1 month and 6 months after operation, respectively. The longitudinal strain parameters at different time points were analyzed and compared in the 3 groups. Results: The regional longitudinal strain of infracted segments in the PCI+IPTC group after the operation within 1 week was higher than that in the PCI group (P<0.05). The left ventricular global longitudinal strain in the PCI+IPTC group seemed to be higher than that in PCI group after the operation within 1 week, but there was not statistically difference (P>0.05). There was no significant difference in the long-term regional and global longitudinal strains of left ventricle between the PCI+IPTC group and the PCI group (both P>0.05). Conclusion: The IPTC can improve the short-term longitudinal systolic function of the reperfused myocardium in patients with acute anterior wall STEMI after PCI.

目的:探讨缺血后处理(ischemic postconditioning,IPTC)是否能改善左心室受损的局部或整体长轴的收缩功能。方法:试验分为PCI组、PCI+IPTC组及对照组。PCI组为前壁急性ST段抬高型心肌梗死患者(ST-segment elevation myocardial infarction,STEMI)患者32例,行首次急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术;PCI+IPTC组为前壁急性STEMI患者28例,行急诊PCI联合IPTC术;对照组为30例,行冠状动脉造影术。采集术前,术后0.5 h,1 d,3 d,1周,1个月和6个月二维动态超声心动图。对比研究PCI组、PCI+IPTC组与对照组各时间点局部与整体长轴应变参数。结果:PCI+IPTC组PCI术后1周内左心室梗死节段长轴应变高于PCI组(P<0.05),左心室整体长轴应变较PCI组有增高趋势,但差异无统计学意义(P>0.05);PCI+IPTC组术后远期左心室局部及整体长轴应变与PCI组比较,差异均无统计学意义(均P>0.05)。结论:IPTC可改善前壁急性STEMI患者PCI术后早期左心室再灌注心肌的长轴收缩功能。.

MeSH terms

  • Anterior Wall Myocardial Infarction*
  • Humans
  • Ischemic Postconditioning*
  • Myocardium
  • Percutaneous Coronary Intervention*
  • ST Elevation Myocardial Infarction*
  • Treatment Outcome
  • Ventricular Function, Left