Document Detail

Degree of residual stenosis of the infarct-related artery. Another variable affecting recovery of regional function after thrombolysis.
MedLine Citation:
PMID:  9717005     Owner:  NLM     Status:  MEDLINE    
AIMS: The aim of this study was to analyse the relationship between infarct-related artery residual stenosis, assessed by quantitative coronary angiography, and left ventricular function changes during the in-hospital period in patients with acute myocardial infarction undergoing thrombolytic treatment. METHODS AND RESULTS: The study population consisted of 90 patients with acute myocardial infarction treated with thrombolysis within 6 h of the onset of symptoms. Left ventricular function was serially assessed by an echocardiographic asynergy score (before thrombolysis and pre-discharge). Left ventricular end-diastolic and end-systolic volumes were also calculated. Coronary stenosis was evaluated by computer-assisted videodensitometric analysis at pre-discharge coronary angiography. Three subgroups were identified on the basis of left ventricular function changes: 25 patients (Group A) with regional myocardial improvement (echo score from 7.5 +/- 3.5 to 4.3 +/- 3.2), 51 (Group B) with no variation in echo score (4.8 +/- 2.7) and 14 (Group C) with myocardial regional worsening (echo score from 4.4 +/- 2.1 to 8.8 +/- 2.4). Group A patients exhibited a very high incidence of infarct-related artery patency (23/25 patients, 92%) vs 71% with unchanged (Group B) and 14% (Group C) with worsening regional left ventricular function (P < 0.001). Subdivision of the study population on the basis of residual stenosis severity showed that a significant improvement in left ventricular function was present only in the subgroup with residual stenosis < 75% (echo score from 5.2 +/- 3.4 to 3.6 +/- 2.9, P < 0.001). CONCLUSION: These results support the important role exerted by complete coronary patency after thrombolysis in inducing left ventricular function recovery, and the poor functional improvement in patients with incomplete coronary patency.
M Penco; A Dagianti; S Romano; C Iacoboni; A Vitarelli; F Fedele; A Dagianti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  19     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-12-11     Completed Date:  1998-12-11     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  727-36     Citation Subset:  IM    
Department of Internal Medicine and Public Health, University of L'Aquila, Rome, Italy.
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MeSH Terms
Collateral Circulation / drug effects,  physiology
Coronary Angiography*
Image Processing, Computer-Assisted
Middle Aged
Myocardial Infarction / drug therapy*,  radiography
Thrombolytic Therapy*
Tissue Plasminogen Activator / administration & dosage
Treatment Outcome
Urokinase-Type Plasminogen Activator / administration & dosage
Ventricular Function, Left / drug effects,  physiology
Reg. No./Substance:
EC Plasminogen Activator; EC Plasminogen Activator

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