806-2 Impact of Thrombolysis on Infarct Expansion and Ventricular Remodeling After Anterior Infarction: One-Year Echocardiographic Follow-up
| Autor: | James D. Thomas, Rade Babić, Aleksandar N. Neskovic, Petar Otašević, Aleksandar D. Popović |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Coronary angiography
medicine.medical_specialty business.industry medicine.medical_treatment Thrombolysis medicine.disease Surgery medicine.anatomical_structure 2d echocardiography Internal medicine Cardiology Medicine Animal studies business Ventricular remodeling Cardiology and Cardiovascular Medicine TIMI Anterior infarction Artery |
| Zdroj: | Journal of the American College of Cardiology. (2):422A |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/0735-1097(95)93212-U |
| Popis: | Animal studies have shown that reperfusion of the infarct-related artery (IRA) may prevent infarct expansion (IE); however, clinical studies investigating the impact of thrombolysis (T) and IRA patency on IE are still rare. We have evaluated 49 consecutive pts with anterior MI by 2D echocardiography on post-MI days 1,2,3,7,21,42 and after 3,6, and 12 months. T was administered in 23 pts (T+) and 26 pts were treated with conventional therapy (T–). LV end-diastolic volume index (EDVi) was determined from apical two- and four-chamber views. Total LV perimeter (TP) and infarct perimeter (IP) were determined in end-diastole in the apical four-chamber view. IE was defined as the increase of IP g5%, with the similar increase of TP on days 2–3, Coronary angiography was performed in 44 pts before discharge; IRA patency was defined as TIMI grade 3. Results IE was detected in 15 pts: 1 T+ and 14 T– pts; IRA was occluded in 11 pts. Absence of IE correlated better with T (r = 0.64, p = 0.001) than with IRA patency (r = 0.48, P = 0,01). In T+ pts, IP significantly decreased from day 2 (p l 0.05) onward. compared to T– pts (Figure). EDVi was higher in pts with IE from day 2 (p = 0.018) through 12 months (p = 0.013). Conclusions 1) These results indicate that T prevents IE in anterior MI, regardless of late IRA patency. It appears that even transient reperfusion induced by T may attenuate IE and prevent LV remodeling. 2) Moreover, Tieads to infarct regression. which is detectable as early as day 2 and continues over 12 months. Download : Download high-res image (90KB) Download : Download full-size image |
| Databáze: | OpenAIRE |
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