Document Detail


Influence of treatment delay on long-term left ventricular function in patients with acute myocardial infarction successfully treated with primary angioplasty.
MedLine Citation:
PMID:  11275927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Myocardial salvage has been shown to be dependent on the time elapsed from the onset of acute myocardial infarction (AMI) to reperfusion. The aim of this study was to evaluate the importance of time to reperfusion for left ventricular function recovery after primary angioplasty (percutaneous transluminal coronary angioplasty [PTCA]) for AMI. METHODS: Ninety-five patients undergoing long-term successful PTCA for AMI were studied. Echocardiography was performed before and 3, 7, 30, 90, and 180 days after PTCA. End-diastolic volume index (EDVI) and end-systolic volume index (ESVI), ejection fraction, and left ventricular wall motion score index (WMSI) were evaluated. RESULTS: Patients were divided into group A, 23 patients reperfused within 2 hours; group B, 32 patients reperfused between 2 and 4 hours; group C, 22 patients reperfused between 4 and 6 hours; and group D, 18 patients reperfused between 6 and 12 hours. Both EDVI and ESVI were reduced in groups A and B at 90 days. Groups C and D did not show any changes of EDVI and ESVI at any stage throughout the study. Ejection fraction improved only in groups A and B at 30, 90, and 180 days. At study entry, WMSI was similar in all groups. After 7 days, in group A and in group B, WMSI was improved, no changes were observed in group C, and a mild deterioration was observed in group D at 3 and 7 days. Subsequent evaluations showed progressive improvement of WMSI in all groups. CONCLUSIONS: Myocardial salvage is achieved only in patients revascularized within 4 hours from AMI onset. However, revascularization after 6 hours may be worthwhile by preventing ventricular remodeling.
Authors:
I Sheiban; G Fragasso; C Lu; S Tonni; G P Trevi; S L Chierchia
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  141     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-03-29     Completed Date:  2001-05-17     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  603-9     Citation Subset:  AIM; IM    
Affiliation:
Divisione di Cardiologia Universitaria, Dipartimento di Medicina Interna, Università di Torino, Ospedale San Giovanni Batista, Corso Bramante 88/90-10126 Torino, Italy. isheiban@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography
Female
Humans
Male
Middle Aged
Myocardial Infarction / physiopathology*,  radiography,  therapy*
Prognosis
Time Factors
Ventricular Function, Left*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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