Document Detail


Prompt improvement of left ventricular function and preservation of topography with combined reperfusion and intravenous nitroglycerin in acute myocardial infarction.
MedLine Citation:
PMID:  9096919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
B I Jugdutt; B L Schwarz-Michorowski; W J Tymchak; J R Burton
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiology     Volume:  88     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:    1997 Mar-Apr
Date Detail:
Created Date:  1997-06-30     Completed Date:  1997-06-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  170-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Alberta, Edmonton, Canada.
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MeSH Terms
Descriptor/Qualifier:
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:
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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