Cardiologia Clínica e Experimental
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Left Ventricular Angiography Post Primary Percutaneous Intervention-does it Predict Subsequent Left Ventricular Dysfunction?

Vinoda Sharma, Tahir Hamid, Kevin AN, Paul Daly, Douglas J Ing, Vladimir Dzavik and Christopher B Overgaard*

Objectives: We aimed to assess whether LV dysfunction assessed by LV angiography (LVA) during PPCI for STEMI predicts subsequent LV dysfunction at follow up. Left ventricular (LV) function as assessed by echocardiography has been demonstrated to improve in the first 6 months following primary percutaneous coronary intervention (PPCI). Data regarding the predictive value of LV angiography (LVA) performed immediately following PPCI are limited.
Methods: A retrospective analysis of our tertiary centre angiographic database was performed (2011-2013). Patients were divided into two groups based on LVA. Group 1: normal or mild LV dysfunction and group 2: moderate or severe LV dysfunction.
Results: Complete dataset was available for 89 patients (of a total of 194). 28.1% (16 patients) in group 1 compared to 46.9% (15 patients) in group 2 failed to improve LV function from baseline as assessed by follow-up echocardiography. LV function on LVA correlated significantly with subsequent LV function at follow up (Spearman’s rho p=0.007). Binary regression analysis demonstrated that Symptom to Balloon Time (STB) was a significant predictor (OR 1.003, 95% CI 1.001-1.005, p=0.008) of lack of LV function recovery at a median follow up of 10 months. Patients in whom the thrombectomy catheter was used were less likely to have abnormal LV function at follow up (OR 0.214, 95% CI 0.063-0.730, p=0.014).
Conclusions: Baseline abnormal LV function on LVA predicted LV dysfunction at follow up. Increased STB time and lack of thrombectomy catheter use are significant predictors of abnormal LV function at follow up.
Condensed abstract: We aimed to assess whether LV dysfunction assessed by LV angiography (LVA) during PPCI for STEMI predicts subsequent LV dysfunction at follow up. A retrospective analysis of our tertiary centre angiographic database was performed (2011-2013). Patients were divided into two groups based on LVA - group 1: normal or mild LV dysfunction and group 2: moderate or severe LV dysfunction. Binary regression analysis demonstrated that Symptom to Balloon Time (STB) was a significant predictor (OR 1.003, 95% CI 1.001-1.005, p=0.008) of lack of LV function recovery at a median follow up of 10 months. Patients in whom the thrombectomy catheter was used were less likely to have abnormal LV function at follow up (OR 0.214, 95% CI 0.063-0.730, p=0.014). Baseline abnormal LV function on LVA predicted LV dysfunction at follow up. Increased STB time and lack of thrombectomy catheter use are significant predictors of abnormal LV function at follow up.