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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...

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Autores principales: 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
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
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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.
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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
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