关键词: 高血压, 心肌梗死, 血压, 心室重构

Abstract: Objective  To investigate the impact of blood pressure after percutaneous coronary intervention (PCI) on ventricular remodeling in patients with acute myocardial infarction (AMI) and primary hypertension. Methods  A total of 265 patients with AMI and  primary hypertension receiving PCI from June 2014 to June 2016 were enrolled. And followups were conducted on them  1 week, 1 month, 3 months and 12 months after PCI. The blood pressure of the patients was measured at each followup，and the echocardiography was performed at 1 month and 12 months after the operation. The risk factors of heart dilatation and the impact of blood pressure on ventricular remodelingin patients with AMI after PCI were analyzed.Results  The risk factors of heart dilatation  in patients with AMI after PCI included heart dilatation in baseline， delayed blood flow perfusion, more  abnormal segments of the ventricular wall movement showed by echocardiography  1 weeks after PCI， poor cardiac functionin 1 weeks after PCI， poor control of blood pressure   after PCI， and low dosage of ACEI/ARB after PCI.  Twelve months after PCI， the left ventricular volume(LVEDV: 109±9 vs 120±9， P=0.014，t=-2.711; LVESV: 80±11 vs 97±8， P=0.001， t=-3.765)  and left ventricular mass(LVMI: 105±12 vs 115±15， P=0.017，t=-2.617)   of  patients with good control of blood pressure were less than that of patients with bad control of blood pressure. Conclusion  The poor control of blood pressure after PCI in patients with AMI is one of the risk factors of heart dilatation. The blood pressure after PCI could impact ventricular remodeling， and higher blood pressure will promote ventricular remodeling.

Key words: hypertension, myocardial infarction, blood pressure, ventricular remodeling