Objective The study was designed to determine that periprocedural intravenous administration of adenosine in acute myocardial infarction patients treated with emergency percutaneous coronary intervention (PCI) could improve segmental myocardial movements and systolic function evaluated by velocity vector imaging (VVI).
Methods 69 patients with acute myocardial infarction undergoing emergency PCI were randomly assigned to the Adenosine Group (n = 34) or the Control Group (n = 35) within 12h of infarct onset. Adenosine was started to infuse 10 min before coronary intervention. VVI was done on the seventh day and 1month after enrollment. 6-month follow-up was performed to observe MACEs.
Results The primary end point was myocardial wall strain and strain rate as well as segmental ejection fraction as determined by VVI. Myocardial systolic function in the Adenosine Group was better than that in the Control Group. Improvements were seen in the adenosine compared with the control group in terms of myocardial wall strain (–13.52 ± 5.61% vs –11.47 ± 5.25%, respectively; P > 0.05), strain rate (–1.08 ± 0.52 vs –0.90 ± 0.44/s, respectively; P < 0.05) and segmental ejection fraction (53.66 ± 12.04% vs 48.40 ± 14.99%, respectively; P < 0.05) on the seventh day. Post Hoc analysis of the 1 month VVI showed ε, SR and Seg EF of adenosine group were higher than control group (P = 0.002, P = 0.001, P = 0.000). Global contractile function was better in the adenosine-treated than control group. At the 6th month follow up, there were no significant differences between groups in terms of the incidence of recurrent angina or heart failure.
Conclusions The periprocedural intravenous administration of adenosine in acute myocardial infarction patients treated with emergency PCI could improve myocardial systolic function and make more segments restored movements. The left ventricular systolic function could be improved by the administration of adenosine. VVI could provide a reliable, portable assessment of myocardial strain and strain rate.