Document Detail


Risk of myocardium adjacent to infarcted myocardium: electrocardiographic, metabolic and scintigraphic evidence within the first week of acute myocardial infarction.
MedLine Citation:
PMID:  3706155     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atrial pacing was carried out within 5 days of an uncomplicated acute myocardial infarction (AMI) in 28 patients to detect the existence of a menaced area. A positive pacing response (at least 1.0 mm of ST-segment shift) was observed in 23 patients (82%, group I), whereas pacing results were negative in 5 (18%, group II). Pacing-induced electrocardiographic changes involved the leads affected by AMI in patients with transmural necrosis. A well-defined thallium-201 redistribution, mostly localized near or within the AMI site, was present in 10 patients from group I (43%), in 1 from group II (20%), and in 1 of 12 comparable patients (8%) in whom pacing was not performed. During pacing, abnormal lactate metabolism was observed in 11 of 17 patients from group I (65%) and in 0 of 5 from group II (0%). A 90% or greater coronary stenosis of at least 1 artery was found in 19 of 23 patients from group I (83%) and in 1 of 5 from group II (20%); 2- to 3-vessel disease (more than 70% diameter stenosis) was present in 14 patients from group I (61%) and 1 from group II (20%). During a 15-month follow-up (range 9 to 25), effort angina developed in 9 patients from group I (39%) and in none from group II. No deaths or reinfarctions occurred in either group. Thus, very early after a first AMI, most patients have a jeopardized periinfarction area that is usually associated with a critical coronary stenosis and that heralds effort angina in a significant proportion of them.
Authors:
J Figueras; J Candell; J Cinca; R Segura; D Ortega; J Angel; J Rius
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  57     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1986 May 
Date Detail:
Created Date:  1986-06-13     Completed Date:  1986-06-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1034-40     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Coronary Vessels / pathology
Electrocardiography
Follow-Up Studies
Heart / physiopathology,  radionuclide imaging
Humans
Lactates / metabolism
Middle Aged
Myocardial Infarction / pathology*,  physiopathology,  radionuclide imaging
Myocardium / pathology*
Necrosis
Risk
Thallium / diagnostic use
Time Factors
Chemical
Reg. No./Substance:
0/Lactates; 7440-28-0/Thallium

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


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