Left Ventricular Function After Primary Percutaneous Coronary Intervention: Role of Speckle Echocardiography

Study Overview
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Brief Summary
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Recovery of the left ventricular function is variable from one patient to another, thus assessment of cardiac function by measuring left ventricular ejection fraction using echocardiography is the most common in the daily clinical practice. However, this technique has limitation related with its intra- and interobserver variability. A recent technique, 2D speckle tracking for assessing global longitudinal strain, has been introduced to reduce the variability and potentially has a higher accuracy. Speckle tracking is a method which uses two dimensions recording for measuring quantity of movement of myocardium in several segments. Speckle-tracking echocardiography is a current noninvasive ultrasound imaging technique that allows for an objective and quantitative evaluation of global and regional myocardial function independently from the angle of insonation and from cardiac translational movements,

Detailed Description
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Authors using 2D speckle tracking found that subclinical LV systolic dysfunction is common in patients with isolated severe mitral stenosis (MS) and is determined primarily by the hemodynamic variables of MS severity and reduced LV filling. BMV results in rapid recovery of LV systolic function in these patients through improvement in LV diastolic loading. These findings suggest that LV contractile properties in MS are modulated predominantly by LV diastolic filling rather than myocardial structural abnormality.

Official Title
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Effect of Residual Myocardial Ischemia on Recovery of Left Ventricular Function After Primary Percutaneous Coronary Intervention

Conditions
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Myocardial Infarction, Echocardiography 2D, Left Ventricular Dysfunction

Intervention / Treatment
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* Diagnostic Test: Speckle tracking echocardiography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with acute myocardial infarction eligible for PCI seen on admission and after 40 days Exclusion Criteria: cardiomyopathy cancer on cytostatic treatment.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group A<br>single coronary artery lesion | Diagnostic Test: Speckle tracking echocardiography<br>* assess left ventricular function on admission and after 40 days<br>* Other names: 2 D echocardiography;|
| Group B<br>multiple coronary artery lesions | Diagnostic Test: Speckle tracking echocardiography<br>* assess left ventricular function on admission and after 40 days<br>* Other names: 2 D echocardiography;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessing change of left ventricular function | measure ejection fraction | baseline and after 40 days of PCI | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major adverse cardiovascular events | non fatal myocardial infarction, non fatal stroke, CV death | 40 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Speckle tracking, 2D echocardiography, Left ventricle residual function, PCI, percutaneous coronary intervention, single coronary artery, multiple coronary arteries