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    
Abstract/OtherAbstract:
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.
Authors:
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    
Affiliation:
Department of Internal Medicine and Public Health, University of L'Aquila, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Collateral Circulation / drug effects,  physiology
Coronary Angiography*
Female
Humans
Image Processing, Computer-Assisted
Male
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
Chemical
Reg. No./Substance:
EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.73/Urokinase-Type Plasminogen Activator

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