Iranian Heart Journal

Iranian Heart Journal

Effect of Primary Percutaneous Coronary Intervention on Diastolic Dysfunction Recovery in Patients With ST-Segment Elevation Myocardial Infarction

Document Type : Original Article

Authors
Ahmed El Barbary
Mahmoud Tantawy
Ibrahim Abdelhamid Ibrahim
Omar Mounir Abdulghaffar
Cardiology Department, Faculty of Medicine, MUST University, Egypt.
Abstract
Background: ST-elevation myocardial infarction (STEMI) is a major cause of heart failure, with left ventricular diastolic dysfunction being a key predictor of adverse outcomes. Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for improving both systolic and diastolic functions. This study aimed to determine the effect of primary PCI on the recovery of diastolic dysfunction in patients with STEMI.
 
Methods: This prospective observational study included 100 patients with STEMI at Misr University for Science and Technology Hospital between September 2023 and February 2024. Key echocardiographic metrics, including deceleration time (DT), E/A ratio, and left atrial volume index (LAVI) were documented at three time points: baseline, immediately following PCI, and at the 3-month follow-up.
 
Results: At baseline, 58% of patients had diastolic dysfunction. Post-PCI left ventricular ejection fraction (LVEF) improved significantly from 34.8% to 51.9% at 3 months (P < 0.001). LA volume and LAVI decreased significantly at 3 months (P < 0.001). DT and isovolumic relaxation time showed significant reductions after PCI (P < 0.001). E/A ratio improved significantly at 3 months (P < 0.001), and 32% of patients demonstrated improvement in diastolic function. The prevalence of diastolic dysfunction was significantly higher among patients who experienced chest pain for a period exceeding 4 hours (P = 0.010).
 
Conclusions: Patients with STEMI demonstrated a significant enhancement in diastolic function after undergoing primary PCI, with notable enhancements in echocardiographic parameters, such as LVEF, E/A ratio, and LAVI. Timely intervention is crucial for optimizing diastolic function recovery. (Iranian Heart Journal 2026; 27(1): 63-70)
Keywords
STEMI
primary PCI
echocardiography
diastolic dysfunction
left ventricular function
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Iranian Heart Journal
Volume 27, Issue 1
Winter 2026
Pages 63-70