The Predictive Value of Tissue Doppler for Left Ventricular Recovery and Remodeling after Primary Percutaneous Coronary Intervention

Background: The main goal in the management of ST segment elevation myocardial infarction (STEMI) is an early restoration of coronary artery flow in order to preserve viable myocardium. Doppler tissue imaging (DTI) is a simple modality that measures tissue velocity during cardiac cycle. Objective: To assess the role of DTIine valuation of LV recovery after PCI. Methods: Fifty patients were included in this study with STEMI, and were candidate for primary PCI. Cardiac enzymes and ECG were done during admission and 12 hours after PCI for assessment of noninvasive criteria for reperfusion. Echocardiography with DTI was performed for all patients to assess LV recovery and remodeling at baseline and one month after PCI. Primary PCI was performed and patients were divided into two groups: Group A with good reperfusion, and group B with poor reperfusion. Results: In patients of group A (78%), there was a statistically significant improvement of the LV EF more than 5% one month after primary PCI (LV recovery) (p <0.001), while in group B, there was a statistically significant increase in LVED volume more than 20% (LV remodeling) (P < 0.01). The mean systolic (S) velocity showed a cutoff value of 4.83cm/sec or more for prediction of recovery of global systolic function with a sensitivity and specificity of 100% and 90% respectively. Out of 11 patients in group B, 3 patients (27.27%) developed MACE and admitted to CCU, 2 of them with heart failure, while other one needed revascularization.