| Prompt improvement of left ventricular function and preservation of topography with combined reperfusion and intravenous nitroglycerin in acute myocardial infarction. | |
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MedLine Citation:
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PMID: 9096919 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Reperfusion alone during acute myocardial infarction (AMI) preserves left ventricular (LV) topography but causes 'stunning', with delayed or no recovery of function. To determine whether adjunctive intravenous nitroglycerin (NTG) accelerates functional recovery, we prospectively measured function and topography by repeated two-dimensional echocardiography between 1 day and 6 months in 5 groups of patients (n = 73) with a first AMI: placebo (group 1), NTG alone (group 2), NTG combined with successful reperfusion after 4 h (group 3) or failed reperfusion (group 4), and successful reperfusion alone (group 5). Asynergy decreased promptly (p < 0.001) and ejection fraction improved (p < 0.001) between day 1 and 6 months in groups 2 and 3 compared to baseline and groups 1, 4 and 5. Infarct expansion and thinning found in group 1 were prevented in groups 2, 3, 4 and 5. Diastolic volume increased in the anterior subgroup 1 but not 2, 3, 4 and 5. This is the first demonstration that reperfusion combined with adjunctive NTG produces earlier, greater and persistent recovery of LV function in addition to attenuation of remodeling in patients after AMI. |
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Authors:
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B I Jugdutt; B L Schwarz-Michorowski; W J Tymchak; J R Burton |
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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: Cardiology Volume: 88 ISSN: 0008-6312 ISO Abbreviation: Cardiology Publication Date: 1997 Mar-Apr |
Date Detail:
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Created Date: 1997-06-30 Completed Date: 1997-06-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 170-9 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of Alberta, Edmonton, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angioplasty, Transluminal, Percutaneous Coronary Combined Modality Therapy Echocardiography* Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / physiopathology, therapy*, ultrasonography Myocardial Reperfusion / methods* Myocardial Stunning / physiopathology, therapy*, ultrasonography Nitroglycerin / administration & dosage* Prospective Studies Streptokinase / administration & dosage Thrombolytic Therapy Treatment Outcome Vasodilator Agents / administration & dosage* Ventricular Function, Left / drug effects*, physiology |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 55-63-0/Nitroglycerin; EC 3.4.-/Streptokinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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