Silent left ventricular dysfunction during routine activity after thrombolytic therapy for acute myocardial infarction

Journal Article · Fri Jun 01 04:00:00 EDT 1990 · Journal of the American College of Cardiology; (USA)

DOI:https://doi.org/10.1016/0735-1097(90)92817-L· OSTI ID:6717517

Kayden, D S; Wackers, F J; Zaret, B L ^[1]

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1. Yale Univ. School of Medicine, New Haven, CT (USA)

To investigate prospectively the occurrence and significance of postinfarction transient left ventricular dysfunction, 33 ambulatory patients who underwent thrombolytic therapy after myocardial infarction were monitored continuously for 187 +/- 56 min during normal activity with a radionuclide left ventricular function detector at the time of hospital discharge. Twelve patients demonstrated 19 episodes of transient left ventricular dysfunction (greater than 0.05 decrease in ejection fraction, lasting greater than or equal to 1 min), with no change in heart rate. Only two episodes in one patient were associated with chest pain and electrocardiographic changes. The baseline ejection fraction was 0.52 +/- 0.12 in patients with transient left ventricular dysfunction and 0.51 +/- 0.13 in patients without dysfunction (p = NS). At follow-up study (19.2 +/- 5.4 months), cardiac events (unstable angina, myocardial infarction or death) occurred in 8 of 12 patients with but in only 3 of 21 patients without transient left ventricular dysfunction (p less than 0.01). During submaximal supine bicycle exercise, only two patients demonstrated a decrease in ejection fraction greater than or equal to 0.05 at peak exercise; neither had a subsequent cardiac event. These data suggest that transient episodes of silent left ventricular dysfunction at hospital discharge in patients treated with thrombolysis after myocardial infarction are common and associated with a poor outcome. Continuous left ventricular function monitoring during normal activity may provide prognostic information not available from submaximal exercise test results.

• OSTI ID: 6717517
• Journal Information: Journal of the American College of Cardiology; (USA), Journal Name: Journal of the American College of Cardiology; (USA) Vol. 15:7; ISSN 0735-1097; ISSN JACCD
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMALS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSIS
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
EXERCISE
HEART
ISOTOPES
MAMMALS
MAN
MYOCARDIAL INFARCTION
ORGANS
PAIN
PATIENTS
PRIMATES
RADIOISOTOPE SCANNING
SYMPTOMS
THALLIUM ISOTOPES
VERTEBRATES