Impact of percutaneous coronary intervention on plasma brain natriuretic peptide levels and ventricular remodeling in patients with acute right ventricular myocardial infarction combined with left ventricular inferior wall or anterior wall myocardial infar

Objective To investigate the impact of percutaneous coronary intervention(PCI) on plasma brain natriuretic peptide(BNP) levels and ventricular remodeling in patients with acute right ventricular myocardial infarction(ARVMI) combined with left ventricular inferior wall myocardial infarction(LVIWMI) or anterior wall myocardial infarction(LVAWMI).Methods Totally 207 patients with ARVMI combined with LVAWMI or LVIWMI were included in the present study.The patients were divided into two groups: ARVMI plus LVIWMI(n=159) and ARVMI plus LVAWMI(n=48).The plasma BNP levels,myocardium enzyme,hemodynamic indices and coronary artery disease were compared between the two groups.The plasma BNP level,left ventricular ejection fraction(LVEF) and left ventricular end diastolic diameter(LVEDd) were observed in patients before and after primary PCI or delayed PCI treatment and in those receiving no PCI.Results We found that the plasma BNP level,CK and CK-MB peak value,pulmonary artery systolic pressure,degree of infarct-related coronary artery and incidence of 2-branch involvement in ARVMI plus LVAWMI group were significantly higher than those in the ARVMI plus LVIWMI group(P0.05).The plasma BNP levels and LVEDd were significantly decreased in patients after treatment with primary PCI or delayed PCI(P0.05),and the plasma BNP level was significantly lower and improvement of LVEDd was significantly greater in patients receiving primary PCI(P0.05).Patients receiving no PCI treatment had a significantly higher mortality compared with those receiving primary or delayed PCI(P0.05).Conclusion Patients with ARVMI plus LVAWMI have higher level of BNP and more severe coronary symptoms.There are noticeable improvement of ventricular remodeling in patients receiving primary PCI,and they also have greatly decreased plasma BNP level.