QUANTITATIVE ANALYSIS OF LEFT VENTRICULAR FUNCTION RECOVERY POST-PERCUTANEOUS CORONARY INTERVENTION IN ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) PATIENTS

Abstract

Left ventricular function plays a pivotal role in maintaining systemic circulation and is often significantly impaired in patients with ST-segment elevation myocardial infarction (STEMI) due to abrupt coronary artery occlusion. This impairment can lead to myocardial necrosis, heart failure, and increased mortality. Percutaneous coronary intervention (PCI) has become the gold standard for restoring coronary perfusion in STEMI, offering substantial benefits in improving left ventricular ejection fraction (LVEF) and reducing mortality. This systematic review examines the recovery of left ventricular function in STEMI patients post-PCI, focusing on key predictors of functional recovery and the impact of timely intervention. Recent studies highlight that the extent of myocardial necrosis, microvascular resistance, reperfusion timing, and individual patient characteristics are critical factors influencing LVEF recovery. Research by Elias et al. (2016) and Otero-García et al. (2021) demonstrated significant improvements in ventricular recovery with PCI, emphasizing the importance of treating viable myocardial tissue. Advanced imaging techniques, such as global longitudinal strain and myocardial work analysis, have been shown to enhance the prediction of recovery potential, as reported by Montaser et al. (2020) and Meimoun et al. (2020). Furthermore, the initial ejection fraction and markers of microvascular function, such as the index of microcirculatory resistance (IMR), were identified as strong predictors of recovery in studies by Dauw et al. (2021) and Palmer et al. (2016). Despite its efficacy in restoring coronary flow and improving systolic function, PCI faces limitations in addressing diastolic dysfunction, which remains a significant clinical challenge. Studies also reveal heterogeneity in patient outcomes, influenced by individual baseline characteristics and the extent of myocardial damage. While PCI improves prognosis, enhances functional recovery, and reduces all-cause and cardiovascular mortality, the integration of advanced diagnostic techniques and precise identification of functional predictors are essential for optimizing treatment outcomes. This review underscores the importance of PCI in STEMI management while highlighting ongoing challenges and opportunities for improving left ventricular function recovery.