Changes in Wall Motion in Patients Treated for Unstable Angina
| Autor: | F. Vermeer, Hein J.J. Wellens, Frits W. Bär, Chris de Zwaan, Willem R.M. Dassen |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Pulmonary and Respiratory Medicine
Hibernating myocardium medicine.medical_specialty Ejection fraction business.industry Unstable angina Critical Care and Intensive Care Medicine medicine.disease Chest pain Coronary artery disease Angina Anistreplase Internal medicine medicine Cardiology Myocardial infarction medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Chest. 108:903-911 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.108.4.903 |
| Popis: | Background A double-blind, placebo-controlled study using anistreplase was performed in 159 patients with unstable angina. All patients had a history of unstable angina combined with typical ECG changes and without evidence of a previous, recent, or ongoing myocardial infarction. The purpose of the present study was to analyze the relationship between the patency of the culprit artery and the behavior of the ischemia-related regional left ventricular (LV) wall motion. Methods and results On entry to the study, all patients received conventional drug therapy: IV nitroglycerin therapy, an oral beta-blocking agent, and a calcium antagonist. Baseline angiography was carried out within 3 h after randomization, a mean of 4.2±3.0 h (range, 1 to 17 h) after the last attack of chest pain. Treatment with trial medication was withheld in 33 cases. Sixty-five patients with coronary artery disease received anistreplase (30 U/5 min)/heparin and 61 patients heparin-only therapy. Angiography was repeated 20.6±4.6 h (mean±SD; range, 12 to 39 h) after the baseline angiographic study. To assess changes in regional myocardial wall motion, the LV wall was divided into seven segments. The ischemia-related coronary artery stenosis was calculated quantitatively and related to the quantitatively assessed mean regional left ventricular ejection fraction (RLVEF) of the ischemia-related segments. In 118 of 126 patients who received trial medication, we found that anistreplase/heparin therapy leads to a significantly (p Conclusion In these patients with unstable angina, the LV wall motion improved both in the treated and the control group at follow-up angiography 1 day later. Improved coronary arterial anatomy was associated with a lesser improvement of the LV contractile function than when worsening of the coronary angiographic appearance occurred. There is no rational explanation of these results. This is a beginning of an effort to elucidate the clinical significance of the stunned and hibernating myocardium in humans. |
| Databáze: | OpenAIRE |
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