Document Detail

Impact of initial degree of coronary narrowing on left ventricular function in first myocardial infarction.
MedLine Citation:
PMID:  20379039     Owner:  NLM     Status:  MEDLINE    
To determine whether the initial degree of coronary narrowing prior to a first myocardial infarction (MI) affects left ventricular function, we analyzed paired coronary angiograms and left ventriculography in 41 consecutive MI patients in whom coronary angiography was obtained before and after MI. Patients were divided into 2 groups according to coronary narrowing of the infarct culprit lesion at first angiogram; a significant narrowing group (group S, 15 patients) and a nonsignificant narrowing group (group N, 26 patients). Significant narrowing was defined as more than 75% stenosis of an infarct-related segment in the first angiography and nonsignificant narrowing was less than 50% narrowing. Clinical characteristics were similar in the two groups, with the exception of initial diameter stenosis. LV function was normal in both groups at initial examination. Group S patients had a higher prevalence of angina prior to MI (73% versus 23%; P = 0.001), good collateral development (73% versus 35%; P = 0.02), and non-Q MI (73% versus 27%; P = 0.004) than group N patients. RWM was also superior in group S compared with group N. The deterioration of global and infarction zone function was mild in group S compared with group N (group S; median EF -10%, RWM -0.27 SD/chord, group N; median EF -26%, RWM -1.62 SD/chord, P = 0.001). We conclude that deterioration of LV wall motion in patients with severe stenosis in their initial stenosis would be milder than in AMI that developed from a mild degree of stenosis.
Shinichiro Yamagami; Katsumi Miyauchi; Hiroyuki Daida
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International heart journal     Volume:  51     ISSN:  1349-2365     ISO Abbreviation:  Int Heart J     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-09     Completed Date:  2010-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  82-5     Citation Subset:  IM    
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
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MeSH Terms
Cohort Studies
Collateral Circulation
Coronary Angiography
Coronary Stenosis / complications,  pathology*,  physiopathology*
Middle Aged
Myocardial Infarction / etiology,  pathology*,  physiopathology*
Retrospective Studies
Risk Factors
Severity of Illness Index
Stroke Volume / physiology
Ventricular Function, Left / physiology*

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