Aim: This study aimed to determine if two-dimensional (2D) speckle tracking of left ventricular ejection fraction (LVEF) could predict six-week remodeling in patients after primary percutaneous coronary intervention (PPCI) for acute ST-segment elevation myocardial infarction (STEMI).

Methods: A prospective study involved 48 patients (41 men, 7 women, average age: 59.3 ± 9.6 years) with acute anterior myocardial infarction. Exclusion criteria included cardiogenic shock, significant valvular disease, prior bypass surgery, and hemodynamic instability. Patients underwent coronary angiography, PPCI, and echocardiography, with tests performed on the day of PPCI and 45 days later. Cardiac parameters were evaluated, and statistical analysis was conducted using SPSS software, with significance defined as P < 0.05.

Results: Among 48 STEMI patients undergoing PPCI, significant improvement was observed in left ventricular (LV) systolic function (P<0.001). Significant changes were also noted in LV size (P<0.01), LVEF (P<0.001), Aortic insufficiency (AI) (P<0.033), and left ventricular hypertrophy (LVH) (P<0.05). No significant differences were found in Right ventricular (RV) size, function, Tricuspid Regurgitation (TR), Mitral Regurgitation (MR), or LV diastolic function. Post-PCI, the number of patients free of left ventricular hypertrophy (LVH) increased from 43.8% to 47.9%.

Conclusion: This study shows that PPCI significantly improves LV function and reduces the need for defibrillator implantation in acute myocardial ischemia patients. Post-PCI, the percentage of patients with an ejection fraction below 35% dropped from 60% to 27% over a six-week follow-up. Despite potential adverse effects, our results confirm PPCI's positive impact. The findings emphasize the importance of timely PPCI and raising public awareness about MI symptoms and the urgency of treatment.

Myocardial infarction, Echocardiography, Percutaneous coronary intervention