Effects of time required for reperfusion (thrombolysis or angioplasty, or both) and location of acute myocardial infarction on left ventricular functional reserve capacity several months later

Journal Article · Mon Apr 15 04:00:00 EDT 1991 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(91)90610-W· OSTI ID:5575554

Little, T; Crenshaw, M; Liberman, H A; Battey, L L; Warner, R; Churchwell, A L; Eisner, R L; Morris, D C; Patterson, R E ^[1]

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1. Emory Univ., Atlanta, GA (USA)

The purpose of this study was to determine whether reperfusion of acute myocardial infarction (AMI) by recombinant tissue-type plasminogen activator (rt-PA) or percutaneous transluminal coronary angioplasty, or both, would improve left ventricular (LV) function when it is measured several months later at rest or maximal bicycle exercise, or both. Radionuclide angiography was performed in 44 patients 5 months (range 6 weeks to 9 months) after AMI to assess function, and tomographic myocardial thallium-201 imaging was performed at maximal exercise and delayed rest to determine whether there was any evidence of myocardial ischemia. As expected, no patient had chest pain or redistribution of a thallium defect during the exercise test, because patients had undergone angioplasty (n = 28) or coronary bypass graft surgery (n = 5) where clinically indicated for revascularization. The LV ejection fraction was plotted as a function of the time elapsed between the onset of chest pain and the time when coronary angiography confirmed patency of the infarct-related artery (achieved in 91% of 44 patients by rt-PA (n = 31) or percutaneous transluminal coronary angioplasty (n = 9) ). Functional responses differed markedly between patients with anterior (n = 20) versus inferior (n = 24) wall AMI. LV ejection fraction during exercise correlated with time to reperfusion in patients with an anterior wall AMI (r = -0.58; standard error of the estimate = 11.9%; p less than 0.02) but not in patients with an inferior AMI (r = 0.10; standard error of the estimate = 13.1%); difference not significant.

• OSTI ID: 5575554
• Journal Information: American Journal of Cardiology; (USA), Journal Name: American Journal of Cardiology; (USA) Vol. 67:9; ISSN 0002-9149; ISSN AJCDA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BETA DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
CORONARIES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EXERCISE
HEART
HEAVY NUCLEI
IMAGE PROCESSING
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MUSCLES
MYOCARDIAL INFARCTION
MYOCARDIUM
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PAIN
PATIENTS
PROCESSING
RADIOISOTOPES
RADIOLOGY
SECONDS LIVING RADIOISOTOPES
SURGERY
SYMPTOMS
THALLIUM 201
THALLIUM ISOTOPES
TOMOGRAPHY