Association of Left Ventricular Systolic Function with Diagonal Branch Flow in Patients with First Anterior ST-Elevation Myocardial Infarction Treated with Primary Angioplasty

Abstract

Background: There are few studies about the impact of diagonal branch blood flow on echocardiographic findings in patients with first acute anterior myocardial infarction undergoing primary angioplasty. Objectives: We aimed to compare left ventricular systolic function measures in patients with first acute anterior ST-segment elevation myocardial infarction (STEMI) treated with primary angioplasty based on diagonal branch blood flow after the procedure. Methods: This study was a single-center study that enrolled patients with their first acute anterior STEMI treated with primary angioplasty in our center between October 2020 and March 2021. Patients were divided into two groups: The patients with final thrombolysis in myocardial infarction (TIMI) flow III in diagonal (sufficient diagonal flow) and patients with final TIMI flow less than III in diagonal (insufficient diagonal flow) after the procedure. The left ventricular Wall-Motion Score Index (WMSI) and left ventricular ejection fraction (LVEF) were compared between the two groups. Results: A total of 107 patients with first anterior STEMI treated with primary PCI were enrolled in the present study, of which 13 patients (12.1%) had insufficient diagonal flow after primary coronary angioplasty. The LVEF was lower in patients with insufficient diagonal flow (32.92 ± 7.29% vs. 39 ± 8.68%, P = 0.018). Also, this group had higher LV WMSI (1.68 ± 0.28 vs. 1.49 ± 0.26, P = 0.029). Conclusions: The present study showed that in patients with first acute anterior STEMI undergoing primary angioplasty, insufficient diagonal branch flow after the procedure was associated with worse left ventricular systolic function and higher LV WMSI.

effectiveness of early angiography and intervention for treating anterior ST-elevation myocardial infarction involving diagonal branches

“…Patients with STEMI in the anterior region of heart have higher in-hospital mortality rates and are more susceptible to complications than with non-anterior MI. This is predominantly owing to the larger size of the infarct and the greater quantity of at-risk myocardium 3 . The diagonal branches are minor arteries that arise from the LAD artery, one of the principal arteries that supply blood to the cardiac muscle.…”

“…Despite the current standard of care, research is ongoing to determine the optimal treatment for anterior STEMI with diagonal branches. Early angiography and intervention have emerged as a promising treatment options, allowing for rapid diagnosis and treatment of the condition, thereby enhancing patient outcomes 3,11 .…”