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Left ventricular function after myocardial infarction has long been recognized as a potent predictor of future survival. But what drives changes in left ventricular ejection fraction (EF) or in scintigraphically determined infarct size (IS) after primary coronary intervention, and are these changes prognostically important?
In 626 patients with an acute first MI treated with mechanical reperfusion, serial scintigraphy and angiography were used to assess IS and EF, respectively. The median perfusion defect covered 24.6% of the left ventricle (LV) at baseline, was reduced to 11% at 7 to 14 days, and was 8% at 6 months. The median EF increased from 51.6% before intervention to 57.4% at 6 months. The degree of LV dysfunction at baseline was inde…