Myocardial wall thickness predicts recovery of contractile function after primary coronary intervention for acute myocardial infarction

OBJECTIVES We sought to determine whether end-diastolic wall thickness (EDWT) can predict recovery of regional left ventricular contractile function after percutaneous coronary intervention (PCI). BACKGROUND Regional contractile function does not recover in all patients after PCI for acute myocardial infarction (AMI). Prediction of functional recovery after AMI may help in clinical decision making. METHODS Forty consecutive patients with AMI were studied with left ventricular contrast echocardiography for accurate wall thickness and function measurement and myocardial perfusion immediately after and two months following PCI. RESULTS Out of 640 segments, 175 (27%) dysfiinctional segments in the infarct territory were analyzed for EDWT, wall function, and perfusion. One hundred and three (59%) dysfunctional segments presented with an EDWT <11 min and 72 (41%) presented with an EDWT greater than or equal to11 mm. Perfusion (partial or complete) was present in 63 segments with an EDWT <11 min (61%) and 71 segments with an EDWT greater than or equal to11 mm. (99%) (p < 0.001). At two months' follow-up, 66 of 72 segments with an EDWT greater than or equal to11 min (92%) improved, whereas only 35 of 103 of the dysfunctional segments with an EDWT <11 min (34%) improved (p < 0.0001). CONCLUSIONS Wall thickness is an easy parameter to predict recovery of function after revascularization. Moreover, combining EDWT and perfusion, segments with an EDWT greater than or equal to11 mm, and presence of perfusion have the highest chance of recovery; segments with an EDWT <11 min and perfusion have an intermediate chance of recovery. In segments with an EDWT <11 min and no perfusion, chances of recovery are very low. (C) 2004 by the American College of Cardiology Foundation