Limitation of Marginal Arteries Flow and Its Impact on Clinical Prognosis In Patients with Acute Inferior ST-Elevation Myocardial Infarction treated with primary Percutaneous Coronary Intervention

Abstract

Background: Importance of marginal arteries revascularization is still unclear, few studies discussed the relationship between limitation of marginal arteries branches flow and clinical outcome of the patients with acute inferior ST-elevation myocardial infarction(STEMI) with culprit lesion in right coronary artery(RCA) or left circumflex(LCX). Aim: To evaluate impact of marginal arteries flow on clinical outcome of patients with acute inferior STEMI treated with Primary Percutaneous Coronary Intervention(PPCI).Methods: This study was carried out in Cardiology Department, Zagazig University on 170 patients represented by first time acute inferior wall myocardial infarction and treated with primary PCI. Patients were divided into group I: Final thrombolysis in myocardial infarction(TIMI)III Flow in (RCA) and right_marginal_arteries(RMAs).or Final TIMI III Flow in (LCX) and left_marginal_arteries (LMAs) and group II: Final TIMI III in RCA and TIMI =<2 in RMAs (subgroup A) or Final TIMI III in LCX and TIMI =<2 in LMAs (subgroup B).Results: There was significant lower mean value of Tricuspid annular plane systolic excursion(TAPSE), tricuspid annular systolic velocity(TASV) in subgroup A compared to subgroup B and significant higher rate of mitral regurgitation in subgroup B compared to subgroup A.Conclusion: Flow limitation RMAs of RCA during Primary PCI in Inferior MI was associated with greater rates of right ventricular(RV) dysfunction and higher rates of heart block compared to Flow limitation in LMAs of LCX. Flow limitation in LMAs of LCX during PPCI in acute inferior MI was associated with greater rates of mitral regurgitation compared to Flow limitation in RMAs of RCA.