Relationship Between Thrombolytic Therapy and Perfusion Defect Detected by Gd-DTPA–Enhanced Fast Magnetic Resonance Imaging in Acute Myocardial Infarction
| Autor: | Yu Nakamura, Takeshi Kondo, Keita Oshima, Masayoshi Sarai, Hiroshi Kurokawa, Takahisa Sato, Taika Kizukuri, Hitoshi Hishida, Yoshihiko Watanabe, Sadako Motoyama, Hirofumi Anno |
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| Rok vydání: | 2001 |
| Předmět: |
Gadolinium DTPA
Male medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Contrast Media Myocardial Reperfusion Text mining Committee report Internal medicine medicine Humans Thrombolytic Therapy Radiology Nuclear Medicine and imaging Myocardial infarction Wall motion Aged Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Stroke Volume Magnetic resonance imaging Thrombolysis Middle Aged Image Enhancement medicine.disease Magnetic Resonance Imaging Echocardiography No reflow phenomenon Cardiology Regression Analysis Female Cardiology and Cardiovascular Medicine business Perfusion |
| Zdroj: | Journal of Cardiovascular Magnetic Resonance. 3:237-245 |
| ISSN: | 1532-429X 1097-6647 |
| DOI: | 10.1081/jcmr-100107472 |
| Popis: | To study whether thrombolytic therapy affects Gd-DTPA-enhanced pattern and whether its pattern indicates myocardial viability, Gd-DTPA-enhanced magnetic resonance imaging (MRI) was performed in 43 patients with reperfused acute myocardial infarction 14.8+/-5.0 days after onset with breathhold scanning on a 1.5-T whole body system. The hypoenhanced area at 90 sec after contrast injection was defined as a perfusion defect (PD). Patients were divided into PD(+) and PD(-) groups. The PD was detected in 77.8% of patients treated with direct percutaneous transluminal coronary angioplasty (PTCA) and in 28.6% of patients treated by thrombolytic therapy with or without PTCA in the thrombolysis in myocardial infarction grade 3 group (p0.05). The myocardial wall was divided into seven segments based on the American Heart Association committee report. Wall motion of each segment was classified by one of six patterns (wall motion score [WMS]: dyskinesis, -1; akinesis, 0; severe hypokinesis, 1; hypokinesis, 2; slight hypokinesis, 3; normal, 4). By echocardiography, the average WMS and ejection fraction were similar between the PD(+) group and the PD(-) group on admission. Those parameters were significantly worse in the PD(+) group than in PD(-) group 1 month after onset. The change in WMS was significantly lower in the PD(+) group than in the PD(-) group. The number of patients and segments with more than two grades of improvement of WMS in the PD(+) group was significantly lower than that in the PD(-) group. Angiographically, left ventricular ejection fraction and WMS of the PD(+) group were significantly lower than those of the PD(-) group 3 months later. PDs were detected significantly less frequently in patients treated with thrombolytic therapy, suggesting that microvascular embolization related to formation of the no-reflow phenomenon. |
| Databáze: | OpenAIRE |
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