Effects of Spontaneous and Streptokinase‐induced Recanalization on Left Ventricular Function After Myocardial Infarction

The effect of recanalization of the “infarct vessel” on left ventricular (LV) function was assessed 6–8 weeks after acute myocardial infarction (MI) in two groups: patients who had streptokinaseinduced recanalization during the acute phase and control patients who had spontaneous recanalization. The ejection fraction and severity of LV wall motion abnormalities in 100 patients with recanalization were compared with those in 78 patients with persistent occlusion of the infarct vessel. Among patients with inferior MI, LV function was significantly better in those with spontaneous (n = 41, p < 0.05) and streptokinase-induced recanalization (n = 15, p < 0.02) than in those with persistent occlusion of the infarct vessel (n = 40) in the control group. The LV function was equally good in patients with spontaneous and streptokinase-induced recanalization. Among anterior MI patients, LV function was significantly better in those with streptokinase-induced recanalization (n = 10) than in those with spontaneous recanalization (n = 34, p < 0.01) or persistent occlusion in the control group (n = 28, p < 0.001). We conclude that recanalization has a beneficial effect on LV function in patients with MI.

[1]  G. Sanz,et al.  Angiographic Findings 1 Month After Myocardial Infarction: A Prospective Study of 259 Survivors , 1982, Circulation.

[2]  K. Gould,et al.  Intracoronary infusion of streptokinase in patients with acute myocardial infarction: effects of reperfusion on left ventricular performance. , 1981, The American journal of cardiology.

[3]  R. Helfant,et al.  Natural History of Contractile Abnormalities After Acute Myocardial Infarction in Man: Severity and Response to Nitroglycerin as a Function of Time , 1981, Circulation.

[4]  K. Kuck,et al.  Nonsurgical Coronary Artery Recanalization In Acute Transmural Myocardial Infarction , 1981 .

[5]  M. Fishbein,et al.  Intracoronary thrombolysis in evolving myocardial infarction. , 1981, Annals of internal medicine.

[6]  P. Rentrop,et al.  Selective Intracoronary Thrombolysis in Acute Myocardial Infarction and Unstable Angina Pectoris , 1981, Circulation.

[7]  M S Golden,et al.  Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. , 1980, The New England journal of medicine.

[8]  E. Braunwald,et al.  Review: Observations on experimental myocardial ischaemia , 1980 .

[9]  S. Epstein,et al.  Natural history of left ventricular function during 1 year after acute myocardial infarction: comparison with clinical, electrocardiographic and biochemical determinations. , 1980, The American journal of cardiology.

[10]  J. Williamson,et al.  Effects of Nifedipine on Myocardial Perfusion and Ischemic Injury in Dogs , 1978, British journal of clinical practice. Supplement.

[11]  K. Schechtman,et al.  The Influence of Location and Extent of Myocardial Infarction on Long-term Ventricular Dysrhythmia and Mortality , 1979, Circulation.

[12]  K. Fox,et al.  The Effects of Nifedipine on Acute Experimental Myocardial Ischemia and Infarction in Dogs , 1979, Circulation research.

[13]  J. Lefebvre,et al.  Coronary arteriography in acute transmural myocardial infarction. , 1979, American heart journal.

[14]  A. Gottschalk,et al.  Sequential radionuclide assessment of left and right ventricular performance after acute transmural myocardial infarction. , 1978, Annals of internal medicine.

[15]  D. Durrer,et al.  Prevalence of right ventricular involvement in inferior wall infarction assessed with myocardial imaging with thallium-201 and technetium-99m pyrophosphate. , 1978, The American journal of cardiology.

[16]  B. Massie,et al.  The Noninvasive Diagnosis of Right Ventricular Infarction , 1978, Circulation.

[17]  S. Effert,et al.  Left ventricular hemodynamics and function in acute myocardial infarction: studies during the acute phase, convalescence and late recovery. , 1977, The American journal of cardiology.

[18]  C. G. Blomqvist,et al.  Cardiovascular Function during Early Recovery from Acute Myocardial Infarction , 1977, Circulation.

[19]  J. Ross,et al.  Coronary arterial reperfusion. III. Early and late effects on regional myocardial function and dimensions in conscious dogs. , 1976, The American journal of cardiology.

[20]  R. Helfant,et al.  Local characteristics of the normal and asynergic left ventricle in man. , 1976, The American journal of medicine.

[21]  H. Henning,et al.  Serial measurements of left ventricular ejection fraction by radionuclide angiography early and late after myocardial infarction. , 1976, The American journal of cardiology.

[22]  P. S. Puri,et al.  Contractile and biochemical effects of coronary reperfusion after extended periods of coronary occlusion. , 1975, The American journal of cardiology.

[23]  M. Weisfeldt,et al.  Right Ventricular Dysfunction Detected by Gated Scintiphotography in Patients with Acute Inferior Myocardial Infarction , 1975, Circulation.

[24]  S. Shanies,et al.  Clinical, hemodynamic and angiographic aspects of inferior and anterior myocardial infarctions in patients with angina pectoris. , 1974, The American journal of cardiology.

[25]  R. Russell,et al.  Left ventricular hemodynamics in anterior and inferior myocardial infarction. , 1973, The American journal of cardiology.

[26]  B. Sobel,et al.  Estimation of Infarct Size in Man and its Relation to Prognosis , 1972, Circulation.

[27]  J. Kastor,et al.  Myocardial changes associated with cardiogenic shock. , 1971, The New England journal of medicine.

[28]  C. Harnarayan,et al.  Quantitative study of infarcted myocardium in cardiogenic shock. , 1970, British heart journal.

[29]  H Sandler,et al.  The use of single plane angiocardiograms for the calculation of left ventricular volume in man. , 1968, American heart journal.

[30]  T. Killip,et al.  Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. , 1967, The American journal of cardiology.

[31]  R. Boucek,et al.  Segmental perfusion of the coronary arteries with fibrinolysin in man following a myocardial infarction. , 1960, The American journal of cardiology.

[32]  F. Yates.  The analysis of contingency tables with groupings based on quantitative characters. , 1948, Biometrika.