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Impact of Impella protected-percutaneous coronary intervention on left ventricle function recovery of patients with extensive coronary disease and poor left ventricular function.
Romagnoli, Enrico; Burzotta, Francesco; Cerracchio, Emma; Russo, Giulio; Aurigemma, Cristina; Pedicino, Daniela; Locorotondo, Gabriella; Graziani, Francesca; Leone, Antonio Maria; D'Amario, Domenico; Lombardo, Antonella; Malara, Silvia; Fulco, Linda; Bianchini, Francesco; Sanna, Tommaso; Trani, Carlo.
Afiliação
  • Romagnoli E; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Burzotta F; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy. Electronic address: francescoburzotta@gmail.com.
  • Cerracchio E; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
  • Russo G; Division of Cardiology, Policlinico Tor Vergata, University of Rome, Rome, Italy.
  • Aurigemma C; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Pedicino D; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Locorotondo G; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Graziani F; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Leone AM; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • D'Amario D; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Lombardo A; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
  • Malara S; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Fulco L; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Bianchini F; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
  • Sanna T; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
  • Trani C; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
Int J Cardiol ; 387: 131098, 2023 09 15.
Article em En | MEDLINE | ID: mdl-37290663
BACKGROUND: The use of Impella support is increasingly adopted to "protect" patients with severe coronary artery disease (CAD) and left ventricle (LV) dysfunction undergoing percutaneous coronary intervention (PCI). AIMS: To evaluate the impact of Impella-protected (Abiomed, Danvers, Massachusetts, USA) PCIs on myocardial function recovery. METHODS: Patients with significant LV dysfunction undergoing multi-vessel PCIs with pre-intervention Impella implantation were evaluated by echocardiography before PCI and at median follow up of 6 months: global and segmental LV contractile function were assessed by LV ejection fraction (LVEF) and wall motion score index (WMSI), respectively. Extent of revascularization was graded using the British Cardiovascular Intervention Society Jeopardy score (BCIS-JS). Study endpoints were LVEF and WMSI improvement, and its correlation with revascularization. RESULTS: A total of 48 high surgical risk (mean EuroSCORE II 8) patients with median LVEF value of 30%, extensive wall motion abnormalities (median WMSI 2.16), and severe multi-vessel CAD (mean SYNTAX score 35) were included. PCIs brought a significant reduction of ischemic myocardium burden with BCIS-JS decrease from mean value of 12 to 4 (p < 0.001). At follow-up, WMSI reduced from 2.2 to 2.0 (p = 0.004) and LVEF increased from 30% to 35% (p = 0.016). WMSI improvement was proportional to the baseline impairment (R - 0.50, p < 0.001), and confined to revascularized segments (from 2.1 to 1.9, p < 0.001). CONCLUSIONS: In patients with extensive CAD and severe LV dysfunction, multi-vessel Impella-protected PCI was associated to an appreciable contractile recovery, mainly determined by regional wall motion improvement in revascularized segments.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Disfunção Ventricular Esquerda / Intervenção Coronária Percutânea Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Disfunção Ventricular Esquerda / Intervenção Coronária Percutânea Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article