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Acute ST-segment elevation myocardial infarction (STEMI) is the acute injury may evolve in the left ventricular remodeling despite effective coronary revascularization and optimal medical therapy and leads to advanced heart failure.The aim of the present study was to assess the effect of management strategy of ST segment elevation myocardial infarction in elderly on LV remodeling and clinical outcome.This study included 150 elderly patients above 60 years old with ST segment elevation myocardial infarction referred to the Coronary care unit, Benha University Hospital.They classified into 3 groups:patients who treated with conservative therapy(Group I),patients who treated with primary percutaneous intervention(Group II) and patients who treated with fibrinolytic therapy(Group III). Standard two-dimensional echocardiography,TDI derived velocity and speckle tracking and 3D echocardiography were used to assess LV remodeling and clinical outcome.Patients of group I were significantly older than those of group II and group III(p value˂0.001). Male gender was more prevalent in patients of 3 groups (P value ˂0.001).Early diastolic mitral annular velocity (e") was significantly reduced in patients of group I and group II compared with patients of group III(p value˂0.001) and the mitral E/e" ratio was significantly higher in patients of group I and group II compared with patients of group III (p value ˂ 0.001).There was no difference in management strategy of ST myocardial infarction patients as regarding conservative therapy, primary coronary intervention and fibrinolytic therapy.

Key words

Primary coronary intervention, LV remodeling, Fibrinolytic therapy, Conservative therapy.