Left ventricular performance and exercise capacity in ... - CiteSeerX
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Original article
Left ventricular performance and exercise capacity in patients aged 65 years and older treated by primary coronary angioplasty or conservatively for acute myocardial infarction – a one-year follow-up Wiesława Pawłowska-Jenerowicz1, Wojciech Drewniak2, Marek Dąbrowski1, 2 1 2
Medical Research Center, Polish Academy of Sciences, Warsaw, Poland Clinical Ward of Cardiology, Bielanski Hospital, Warsaw, Poland
Abstract Background: Elderly patients hospitalised for congestive heart failure (CHF) due to myocardial infarction (MI) have very poor prognosis, particularly if CHF symptoms are caused by left ventricular (LV) systolic dysfunction. Early invasive strategy is considered the best method of preventing post-MI LV dysfunction. The clinical impact of early invasive strategy on prognosis in elderly patients with acute MI has yet to be completely defined because of the poor enrolment of elderly patients in large randomised trials. Aim: To asses whether treatment of acute MI in patients aged >65 years using percutaneous coronary intervention (PCI) results in significantly better long-term cardiovascular performance in comparison with conservative treatment (CT). Methods: Our study involved 90 MI patients who underwent diagnostic spiroergometry: 40 patients (mean age 73 years) treated conservatively and 50 (mean age 71 years) by PCI. Echocardiographic examinations and spiroergometric tests were performed at 3-, 6- and 12-month follow-up. Plasma NT-proBNP levels were measured on admission and at 6- and 12-month follow-up. Results: Echocardiographic and spiroergometric parameters were significantly better in PCI patients in each of the analysed periods and showed significant improvement throughout follow-up (the largest between months 3 and 6). In the CT patients these parameters showed significant improvement only between months 3 and 6. After one year, studied parameters were better in PCI patients (LVESD: 3.1±0.4 vs. 3.5±0.6 cm; p
