الفهرس 
Definition of acute myocardial infarctionOnly 14 pages are availabe for public view
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Abstract
Cardiovascular diseases are currently the leading cause of death inindustrialized countries and are expected to become so in developingcountries.[1]Left ventricular (LV) dysfunction is the single strongest predictor ofmortality and one of the most frequent and deadly complications followingST segment elevation myocardial infarction , and this complication has beengreatly reduced in the era of primary PCI.[3]Heart rate is a physical sign that is easily and noninvasively measuredwithout special training or equipment and discharge heart rate followingSTEMI has been associated with all-cause and cardiovascular mortality andheart failure hospitalization at 30-day and long-term follow-up.[96]This work aimed at studying discharge heart rate as a predictor ofdevelopment of LV adverse remodeling , which is defined as more than 20 %increase in LV end diastolic volume as assessed by Simpson‘s method .This study was conducted on 60 patients with first STEMI presentedto Tanta university hospitals and treated by primary PCI.The study duration was six months from July 2018 to December2018, the patient were treated by primary PCI within 12 hours ofpresentation.The study populations were divided into two groups according todevelopment of LV remodeling; group I without LV remodeling including38 patients and group II who developed LV remodeling including 22 patientsThe two groups were assessed as regard discharge heart rate (DHR),laboratory investigations, angiographic results and echocardiographicparameters at discharge and after 3 months. Echocardiography assessment included:• Left ventricular end diastolic volume at discharge and after 3months.• Ejection fraction by Simpson‘s method.• LV filling pressure (E/e‘).Higher discharge heart rate (DHR) was a significant predictor of LVadverse remodeling.These findings support the growing body of evidence recognizing theimportance of heart rate as a modifiable risk factor in cardiovascular disease.Other predictors for developing LV remodeling were older age, malesex, lower discharge EF , Diabetes mellitus , Hypertension , LAD as a culpritvessel and multi vessel disease .The independent predictors were higher discharge heart rate , LAD asculprit vessel , HTN and discharge E/e‘.Other parameters that were not significant in prediction of LVremodeling included smoking, family history of CAD, peripheral arterialdisease, dyslipidemia, symptoms to balloon time and end diastolic volume ondischarge.