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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease

1
Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
2
Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
*
Author to whom correspondence should be addressed.
This research was funded by a grant (No. MIP-116/2011) from the Research Council of Lithuania. This research was performed in cooperation with Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Lithuania.
Medicina 2015, 51(1), 38-45; https://doi.org/10.1016/j.medici.2015.01.005
Received: 28 October 2013 / Accepted: 16 January 2015 / Published: 28 January 2015
Objective: The aim of this study was to investigate the impact of admission systolic blood pressure (ASBP) and left ventricular (LV) mass on the postreperfusion LV recovery in patients with ST-segment elevation myocardial infarction (STEMI) and concomitant coronary multi- vessel disease (MVD).
Materials and methods: A retrospective analysis of 12-month postreperfusion LV recovery was performed in 104 patients after primary percutaneous coronary intervention (PPCI). Patients with elevated ASBP (>140 mmHg) were assigned to the first group ( n = 58); with normal ASBP (<140 mmHg), to the second group ( n = 46); with increased myocardial mass index (MMI) (>100 g/m2), to the third group ( n = 70); and with normal MMI (<100 g/m2), to the fourth group ( n = 34). Severity of MVD was evaluated by the Syntax score. The LV recovery was assessed by evolution of quantitative characteristics of electrocardiography (QRS score, ST score, ECG STEMI stage) and echocardiography (LV ejection fraction, volume and mass indices) registered before and after PPCI, at discharge, and after 1, 6, and 12 months.
Results: There were no significant differences in the baseline QRS and ST scores, ECG STEMI stage, LVEF, MMI, and Syntax score comparing all the patients' groups. The serial ECG criteria showed only a very small impact of ASBP on postreperfusion LV recovery. Only ECG STEMI stage progression was slower in the patients with elevated ASBP. In patients with different MMI, the QRS and ST scores were higher and ECG STEMI stage was lower in patients with increased MMI. LVEF after 1 year was significantly lower in the third group as compared to the fourth group (42.58%  8.25% vs. 46.8%  7.13%, P = 0.018).
Conclusion: Postreperfusion LV recovery was more related not to ASBP but to the increased LV mass assessed by echocardiography in patients with STEMI and MVD.
Keywords: Primary percutaneous coronary intervention; Multivessel coronary artery disease; Postreperfusion left ventricle recovery; Left ventricular function Primary percutaneous coronary intervention; Multivessel coronary artery disease; Postreperfusion left ventricle recovery; Left ventricular function
MDPI and ACS Style

Vaicekavičius, E.; Vasiliauskas, D.; Navickas, R.; Milvidaitė, I.; Unikas, R.; Venclovienė, J.; Kubilius, R. Impact of hypertension on postreperfusion left ventricular recovery in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease. Medicina 2015, 51, 38-45.

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