A comparision of left ventricular functions after acute myocardial infarction receiving different reperfusion therapy

Background : It is demonstrated that primary angioplasty is more effective than thrombolytic therapy on the clinical outcomes in ST- segment elevation acute myocardial infarction (STEMI). The aim of this study was to compare the effects of reperfusion therapies on left ventricular systolic and diastolic functions. Methods : We assigned 114 patients (19 female, mean age 60.2 ± 10.7 years, and 95 male, mean age 53.6 ± 11.0 years) with first STEMI treated with primary angioplasty (n=54) or thrombolytic drug therapy (n=60) in accordance with selection criteria. Assesment of LV systolic function was done by wall motion score index (WMSI) and left ventricular ejection fraction( LVEF). Left ventricular diastolic function was evaluated by the pulsed Doppler technique Results : WMSI was significantly lower in angioplasty group  (1.31 ± 0.30) compared to thrombolysis group (1.45 ± 0.40)  (P 0.05). The frequency of diastolic dysfunction tended to lower in angioplasty group but the difference was not significant (50% vs 62%, P>0.05). Nevertheless, rates of restrictive filling pattern cases was significantly higher in thrombolysis group ( 7% vs 22%, P<0.05 ). There was a significant difference for E/A ratio between two groups (0.99± 0.38 versus 1.20± 0.60, P<0.05). Conclusions : The results showed that the left ventricular systolic and diastolic functions were preserved with STEMI treated by primary angioplasty. This may contribute to better clinical outcomes in patients with STEMI treated with primary angioplasty.