الفهرس 
AbstractOnly 14 pages are availabe for public view
 |  | from | 85 |  |  |
| | | from | 85 | | |
Abstract
Introduction: A history of hypertension has been linked to an increased risk of adverse outcomes after AMI, including stroke, heart failure, and cardiovascular death, according to several studies. In a multivariate analysis, a history of hypertension independently contributed to higher in-hospital mortality in AMI patients but not to one-year mortality. This was due to the coexistence of other risk factors (old age, high Killip class, multivessel disease) .[120]–[124]from the first land-mark 1967 Veterans Administration Cooperative Study to the 2021 SPRINT trial, all outcome trials in hypertension have used the average of snapshot BP levels to demonstrate the efficacy of antihypertensive drug therapy in reducing cardiovascular risk. In all of these studies, the variable nature of BP levels has been ignored.[12]–[14]There are three types of blood pressure variability: (a) Ultra short-term BPV which characterizes the fluctuation of the blood pressure from bear to beat. (b) Short term BPV which characterizes the fluctuation of the blood pressure from minutes to hours. (c) Long term BPV which characterizes the fluctuation of the blood pressure from visit to visit and from day to day.[6] Preclinical studies have clearly proved the role of BPV in cardiovascular events. The Sino-aortic denervated (SAD) rat is an excellent experimental model for studying the effects of BPV on target organs because SAD increases variability in BP without affecting mean values. Absence of carotid and aortic baroreceptor afferents in SAD rats causes a chronic increase in short-term BPV without affecting mean blood pressure values.[21] A recent meta-analysis showed that increased long-term variability in systolic blood pressure was linked to an increased risk of all-cause mortality, cardiovascular disease mortality, cardiovascular disease events, coronary heart disease, and stroke. Increased short-term variability in daytime systolic blood pressure was also linked to all-cause mortality.[119] Many recent studies have assessed the prognostic role of BPV in STEMI patients, and most of them have demonstrated a positive correlation between increased BPV and cardio-vascular morbidity, cardio-renal events, heart failure hospitalisation and development of a new onset AF during long term follow up. These findings could imply that patients suffering from MI and exhibiting increased BPV during hospitalisation should be closely monitored. Aim of the study: To assess the effect of short-term blood pressure variability (BPV) on myocardium viability and residual ischemia in ST-segment elevation myocardial infarction (STEMI) patients after primary per-cutaneous coronary intervention (1ry PCI).Patients and methods: Our study group is 42 ST-segment elevation myocardial infarction (STEMI) patients who underwent primary per-cutaneous coronary intervention, All the patients underwent 24 hours ambulatory blood pressure monitoring (ABPM). We calculated blood pressure variability as the average real variability (ARV) of systolic and diastolic blood pressure during 24 hours ambulatory blood pressure monitoring (ABPM). All the patients underwent myocardial Single photon emission computed tomography (SPCT) imaging 1 to 3 Months after primary per-cutaneous coronary intervention (1ry PCI) to assess viability and residual ischemia.Results: There was no significant linear correlation between the blood pressure variability and myocardium viability &residual ischemia after primary per-cutaneous coronary intervention (1ry PCI) among the studied patients (P-value>0.05).