Effects of delayed opening of infarct-related artery on late left ventricular remodeling in patients with acute anterior myocardial infarction

Objective To assess the effect of delayed opening of the infarct-related artery (IRA)by percutanous coronary intervention(PCI)on the late left ventricular remodeling after acute anterior myocardial infarction. Methods Sixty-four patients with initial Q-wave anterior myocardial infarction and the infarct-related arteries were total occluded conformed by angiogram at 10 to 21 days after onset were divided into successful PCI group and control group(not receiving PCI or the IRA not re-opened). Two-DE was performed at acute phase(about 3 weeks),2 and 6 months after onset of AMI respectively to detect the left ventricular function and left ventricular wall motion abnormality (VWMA). The total congestive heart failure events were recorded during 6 months follow-up. Results VWMA scores, left ventricular ejection fraction (LVEF),left ventricular end-diastolic and end-systolic volume indexes(LVEDVI and LVDSVI)were similar in 2 groups at acute phase and 2 months. There were no differences between acute phase and 2 months in each group too. VWMA scores and LVEF did not changed at 6 months in each group compared with acute phase and 2 months (P 0.05). But LVEDVI and LVESVI were significantly smaller in the successful PCI group than in the control group (P 0.01, P 0.05). The congestive heart failure events were taken place in 19% of patients in control group compared with 2% in successful PCI group (P0.05). Conclusions Delayed opening of IRA in acute anterior myocardial infarction can prevent the late phase but not the early phase of left ventricular remodeling after AMI.