Cargando…
Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction
Aim: The aim of our study is to assess the predictors and the prognostic role of left ventricle ejection fraction (LVEF) recovery after Impella-supported percutaneous coronary intervention (PCI) in patients presenting with acute myocardial infarction (AMI). Methods: This retrospective, observational...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604820/ https://www.ncbi.nlm.nih.gov/pubmed/36294715 http://dx.doi.org/10.3390/jpm12101576 |
_version_ | 1784817910702669824 |
---|---|
author | Marin, Federico Pighi, Michele Zucchelli, Federico Ruzzarin, Alessandro Russo, Giulio Aurigemma, Cristina Romagnoli, Enrico Ferrero, Valeria Piccoli, Anna Scarsini, Roberto Pesarini, Gabriele Trani, Carlo Burzotta, Francesco Ribichini, Flavio Luciano |
author_facet | Marin, Federico Pighi, Michele Zucchelli, Federico Ruzzarin, Alessandro Russo, Giulio Aurigemma, Cristina Romagnoli, Enrico Ferrero, Valeria Piccoli, Anna Scarsini, Roberto Pesarini, Gabriele Trani, Carlo Burzotta, Francesco Ribichini, Flavio Luciano |
author_sort | Marin, Federico |
collection | PubMed |
description | Aim: The aim of our study is to assess the predictors and the prognostic role of left ventricle ejection fraction (LVEF) recovery after Impella-supported percutaneous coronary intervention (PCI) in patients presenting with acute myocardial infarction (AMI). Methods: This retrospective, observational study included patients admitted for AMI who underwent Impella-supported PCI in two Italian high-volume cardiac catheterization laboratories. Only patients who underwent an echocardiographic assessment of left ventricle ejection fraction (LVEF) before the procedure (acute LVEF) and during follow-up (follow-up LVEF) were included in the present analysis. Patients with a baseline LVEF ≥40% were excluded from the present analysis. LVEF recovery was calculated as the difference between follow-up LVEF and acute LVEF. A delta ≥5% was considered significant and was used to define the responder group. Results: From April 2007 to December 2020, 64 consecutive patients were included in our study. A total of 55 patients (86%) received hemodynamic support with Impella 2.5, and 9 patients (14%) with Impella CP. Median LVEF at follow-up was significantly higher compared to baseline (36% (30–42) vs. 30% (24–33), p < 0.001). Based on LVEF recovery, 37 patients (57.8%) were deemed responders. According to multivariate analysis, complete functional revascularization was an independent predictor of a significant EF recovery (OR: 0.159; 95% CI: 0.038–0.668; p = 0.012). At three-year follow-up, lack of LVEF recovery was the only predictor of mortality (HR: 5.315; 95% CI: 1.100–25.676; p = 0.038). Conclusions: Functional complete revascularization is an independent predictor of the recovery of LVEF in patients presenting with AMI who underwent Impella-supported PCI. The recovery of LV function is associated with improved prognosis and could be used to stratify the risk of future events at long-term follow-up. |
format | Online Article Text |
id | pubmed-9604820 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96048202022-10-27 Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction Marin, Federico Pighi, Michele Zucchelli, Federico Ruzzarin, Alessandro Russo, Giulio Aurigemma, Cristina Romagnoli, Enrico Ferrero, Valeria Piccoli, Anna Scarsini, Roberto Pesarini, Gabriele Trani, Carlo Burzotta, Francesco Ribichini, Flavio Luciano J Pers Med Article Aim: The aim of our study is to assess the predictors and the prognostic role of left ventricle ejection fraction (LVEF) recovery after Impella-supported percutaneous coronary intervention (PCI) in patients presenting with acute myocardial infarction (AMI). Methods: This retrospective, observational study included patients admitted for AMI who underwent Impella-supported PCI in two Italian high-volume cardiac catheterization laboratories. Only patients who underwent an echocardiographic assessment of left ventricle ejection fraction (LVEF) before the procedure (acute LVEF) and during follow-up (follow-up LVEF) were included in the present analysis. Patients with a baseline LVEF ≥40% were excluded from the present analysis. LVEF recovery was calculated as the difference between follow-up LVEF and acute LVEF. A delta ≥5% was considered significant and was used to define the responder group. Results: From April 2007 to December 2020, 64 consecutive patients were included in our study. A total of 55 patients (86%) received hemodynamic support with Impella 2.5, and 9 patients (14%) with Impella CP. Median LVEF at follow-up was significantly higher compared to baseline (36% (30–42) vs. 30% (24–33), p < 0.001). Based on LVEF recovery, 37 patients (57.8%) were deemed responders. According to multivariate analysis, complete functional revascularization was an independent predictor of a significant EF recovery (OR: 0.159; 95% CI: 0.038–0.668; p = 0.012). At three-year follow-up, lack of LVEF recovery was the only predictor of mortality (HR: 5.315; 95% CI: 1.100–25.676; p = 0.038). Conclusions: Functional complete revascularization is an independent predictor of the recovery of LVEF in patients presenting with AMI who underwent Impella-supported PCI. The recovery of LV function is associated with improved prognosis and could be used to stratify the risk of future events at long-term follow-up. MDPI 2022-09-24 /pmc/articles/PMC9604820/ /pubmed/36294715 http://dx.doi.org/10.3390/jpm12101576 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Marin, Federico Pighi, Michele Zucchelli, Federico Ruzzarin, Alessandro Russo, Giulio Aurigemma, Cristina Romagnoli, Enrico Ferrero, Valeria Piccoli, Anna Scarsini, Roberto Pesarini, Gabriele Trani, Carlo Burzotta, Francesco Ribichini, Flavio Luciano Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction |
title | Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction |
title_full | Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction |
title_fullStr | Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction |
title_full_unstemmed | Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction |
title_short | Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction |
title_sort | predictors and prognostic impact of left ventricular ejection fraction recovery after impella-supported percutaneous coronary interventions in acute myocardial infarction |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604820/ https://www.ncbi.nlm.nih.gov/pubmed/36294715 http://dx.doi.org/10.3390/jpm12101576 |
work_keys_str_mv | AT marinfederico predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT pighimichele predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT zucchellifederico predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT ruzzarinalessandro predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT russogiulio predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT aurigemmacristina predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT romagnolienrico predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT ferrerovaleria predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT piccolianna predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT scarsiniroberto predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT pesarinigabriele predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT tranicarlo predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT burzottafrancesco predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction AT ribichiniflavioluciano predictorsandprognosticimpactofleftventricularejectionfractionrecoveryafterimpellasupportedpercutaneouscoronaryinterventionsinacutemyocardialinfarction |