| Heterogeneous fate of perfusion and contraction after anterior wall acute myocardial infarction and effects on left ventricular remodeling. | |
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MedLine Citation:
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PMID: 9874047 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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After acute myocardial infarction, patency of infarct vessel and extent of left venticular (LV) dysfunction are major determinants of ventricular remodeling. Spontaneous, delayed reperfusion in the infarct zone occurs in a sizeable number of patients well after the subacute phase. The aim of this study was to determine the relation between the occurrence of this spontaneous, delayed reperfusion and LV remodeling. In 84 patients, resting LV volumes, topography, regional function, and perfusion were quantitatively evaluated by 2-dimensional echocardiography and sestamibi tomography 5 weeks (study 1) and 7 months (study 2) after anterior Q-wave infarction. At study 2, LV end-diastolic volume increased by > 15% in 17 patients (20%, LV remodeling); they had already had at study 1 significantly larger LV volumes, more severe hypoperfusion and wall motion abnormalities, and greater regional dilation than patients with stable LV volumes. Delayed reperfusion occurred in 8 of 17 patients with and in 42 of 67 patients without LV remodeling (47% vs 63%; p=NS). At study 2, LV regional dilation and end-diastolic volumes were stable in patients with, but increased in patients without, spontaneous reperfusion (from 25+/-24% to 29+/-26% at study 2 [p<0.05] and from 65+/-14 to 68+/-18 ml/m2 [p <0.05]). At multivariate analysis, however, regional ventricular dilation at study 1 was the sole predictor of further LV remodeling. Thus, after acute myocardial infarction, spontaneous reperfusion occurring after 5 weeks plays only a minor role in influencing LV remodeling. Benefits from delayed reperfusion seem limited to patients with preserved LV volumes; patients with an enlarged left ventricle 5 weeks after acute infarction are prone to further LV remodeling, irrespective of delayed reperfusion. |
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Authors:
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C Marcassa; M Galli; R Bolli; P L Temporelli; R Campini; P Giannuzzi |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 82 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1998 Dec |
Date Detail:
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Created Date: 1999-01-19 Completed Date: 1999-01-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1457-62 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Division, Salvatore Maugeri Foundation IRCCS, Medical Institute of Rehabilitation of Veruno, Italy. cdl@intercom.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Coronary Angiography Coronary Circulation* Echocardiography Humans Male Middle Aged Multivariate Analysis Myocardial Infarction / physiopathology* Predictive Value of Tests Prospective Studies Radiopharmaceuticals / diagnostic use Technetium Tc 99m Sestamibi / diagnostic use Time Factors Ventricular Dysfunction, Left / diagnosis*, physiopathology* Ventricular Remodeling* |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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