Left Ventricular Dysfunction in Acute ST-Elevation Myocardial Infarction

Background: Left ventricular dysfunction (LVD) following acute myocardial infarction (AMI) significantly worsens prognosis. Early detection is crucial for implementing evidence-based therapies to improve outcomes.

Objectives: To determine the incidence and types of LVD in patients with acute ST-elevation myocardial infarction (STEMI), identify associated clinical factors, and evaluate the impact of successful reperfusion.

Methods: This prospective observational study enrolled 110 STEMI patients without prior cardiac disease, admitted between April and October 2024. Echocardiographic evaluation during hospitalization assessed systolic LVD (ejection fraction <40%) and diastolic LVD (normal EF with dilated left atrium and abnormal Doppler findings). Associations between LVD, clinical characteristics, risk factors, and thrombolysis outcomes (successful vs. failed reperfusion) were analyzed using Chi-square and Z-tests.

Results: LVD was observed in 62.9% of patients, with systolic dysfunction in 42.7% and diastolic dysfunction in 20.0%. LVD was associated with higher heart rates, lower blood pressure, larger LV/LA dimensions, and reduced EF and fractional shortening (P<0.05–P<0.001). Diabetes, hypertension, and smoking were significant predictors of LVD. Successful reperfusion significantly reduced the incidence of LVD (35.4% in responders vs. 81.0% in non-responders, P<0.001) and affected the type of dysfunction (P<0.05).

Conclusion: LVD is highly prevalent among acute STEMI patients and closely linked to traditional cardiovascular risk factors. Successful reperfusion significantly mitigates LVD development. Echocardiography plays a vital role in early diagnosis, risk stratification, and guiding management in this population.