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Predictive Factors for the Recovery of Left Ventricular Dysfunction in Patients with Acute Myocardial Infarction

좌심실 부전증이 발생한 급성 심근경색증 환자에서 좌심실 기능 개산 관련 인자

  • Lim, Sang-Chun (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Rhee, Jung-Ae (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Choi, Jin-Soo (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Shin, Eun-Suk (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Kim, Kye-Hun (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Kim, Ju-Han (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Moon, Jae-Youn (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Hong, Young-Joon (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Ahn, Young-Keun (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Cho, Jeong-Gwang (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Park, Jong-Chun (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Kang, Jung-Chaee (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Jeong, Myung-Ho (The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences)
  • 임상춘 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 이정애 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 최진수 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 신은숙 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 김계훈 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 김주한 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 문재연 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 홍영준 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 안영근 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 조정관 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 박종춘 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 강정채 (전남대학교병원 심장센터, 전남대학교 의과학연구소) ;
  • 정명호 (전남대학교병원 심장센터, 전남대학교 의과학연구소)
  • Published : 2007.03.30

Abstract

Background and Objectives:The left ventricular ejection fraction (LVEF) is known to be a significant prognostic factor for patients with acute myocardial infarction (AMI). The aim of this study was to investigate clinical or therapeutic factors associated with the recovery of a low LVEF for patients with AMI. Subjects and Methods: From January to December 2004, we enrolled 89 patients (mean age: 62.5±10.6 years, 43 males and 26 females) with AMI and who had a LVEF less than 50%. Forty five patients whose LVEF improved more than 10% were classified as group I (mean age: 62.4±10.4 years, 34 males and 11 females) and 44 patients whose LVEF was not changed or decreased were classified as group II (mean age: 62.3±10.9 years, 29 males and 15 females). The clinical variables, including risk factors and the pain-to-door time, the biochemical markers of myocardial injury, the coronary angiographic findings and the treatment-related variables, were compared between the two groups. Results:The cardiovascular risk factors were not different between the groups. The location of infarction, the success rate of percutaneous coronary intervention and the coronary angiographic lesion morphologies were not different between the groups. However, the pain-to-door time was significantly shorter in group I than in group Ⅱ (6.0±9.5 vs 22.4±7.5 hours, respectively, p=0.046). Improved control of risk factors was not associated with the recovery of LV function. The use of beta-blocker, statin, anti-platelet agents, vasodilators and diuretics were not different between the groups. However, the use of angiotensin converting enzyme inhibitor (ACEI) was more common in group Ⅰ than group Ⅱ (79.3% vs 47.4%, respectively, p=0.03). Conclusion:A shorter pain-to-door time and the use of ACEI were significant predictors of the recovery of LV dysfunction for patients with AMI. (Korean Circulation J 2007;37:113-118)

Keywords

References

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