Document Detail


Ventricular endocrine and mechanical function following thrombolysis for acute myocardial infarction.
MedLine Citation:
PMID:  17157397     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to assess natriuretic peptide release following acute myocardial infarction, and its relationship with ventricular function. METHODS: A total of 44 patients with acute myocardial infarction were studied; 13 anterior, age (57+/-12 years) and 31 inferior, age (58+/-12 years). Peptide levels and left ventricular function by echocardiography were assessed at admission and on days 7 and 30 after thrombolysis. Healthy volunteers (n=21) served as controls. RESULTS: Atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) levels rose from admission to day 7 (p=0.002). While ANP remained elevated at day 30 in both groups, BNP levels fell in patients with anterior myocardial infarction (p=0.03). Left ventricular fractional shortening was reduced at admission in the two groups (p=0.01) but returned towards normal in 7 days (p=0.001) in inferior myocardial infarction and in 30 days in anterior myocardial infarction (p=0.02). Left ventricular long axis amplitude was universally reduced at admission (p=0.01) and remained abnormal at day 30 (p=0.01) in both groups. At day 7, BNP and ANP levels inversely correlated with long axis amplitude of lateral wall in anterior myocardial infarction; (r=-0.7, p=0.01). BNP correlated inversely with fractional shortening in anterior myocardial infarction (r=-0.7, p=0.01) at day 30. CONCLUSION: The elevated peptide levels at 7 days post-myocardial infarction correlate with reduced mechanical activity of the adjacent noninfarcted segment. Natriuretic peptides release seem to be related to failure of compensatory hyperdynamic activity of the noninfarcted area rather than directly from the injured myocardial segments.
Authors:
Ihab S Ramzy; Caroline A Daly; Christine A O'Sullivan; Yat-Yin Lam; Michael Kemp; James Hooper; Mark Dancy; Michael Y Henein
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-12-08
Journal Detail:
Title:  International journal of cardiology     Volume:  117     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-19     Completed Date:  2007-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  51-8     Citation Subset:  IM    
Affiliation:
Central Middlesex Hospital, Cardiology Department, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Atrial Natriuretic Factor / blood*
Biological Markers / blood
Female
Fibrinolytic Agents / therapeutic use
Humans
Male
Middle Aged
Myocardial Infarction / blood,  classification,  physiopathology*,  therapy*
Natriuretic Peptide, Brain / blood*
Thrombolytic Therapy*
Tissue Plasminogen Activator / therapeutic use
Ventricular Function*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fibrinolytic Agents; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor; EC 3.4.21.68/Tissue Plasminogen Activator

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