Relation between infarct size and left ventricular performance assessed in patients with first acute myocardial infarction randomized to intracoronary thrombolytic therapy or to conventional treatment
Autor: | Ernst E. van der Wall, Peter L. M. Kerkhof, Frits W. Bär, Arnoud van der Laarse, Maarten L. Simoons, X.Hanno Krauss, Wim T. Hermens, Frank Vermeer, Patrick W. Serruys, Freek W.A. Verheugt |
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Přispěvatelé: | Physics and medical technology, Radiology and nuclear medicine |
Rok vydání: | 1988 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Streptokinase Myocardial Infarction Hemodynamics Creatine chemistry.chemical_compound Random Allocation Internal medicine medicine Humans Myocardial infarction cardiovascular diseases Fibrinolysin Chemotherapy Ejection fraction biology business.industry Angiography Stroke Volume medicine.disease Infarct size chemistry biology.protein Cardiology cardiovascular system Creatine kinase Cardiology and Cardiovascular Medicine business medicine.drug |
Zdroj: | The American Journal of Cardiology, 61(1), 1-7. Elsevier Inc. Van Der Laarse, A, Kerkhof, P L M, Vermeer, F, Serruys, P W, Hermens, W T, Verheugt, F W A, Bär, F W, Krauss, X H, Van Der Wall, E E & Simoons, M L 1988, ' Relation between infarct size and left ventricular performance assessed in patients with first acute myocardial infarction randomized to intracoronary thrombolytic therapy or to conventional treatment ', The American Journal of Cardiology, vol. 61, no. 1, pp. 1-7 . https://doi.org/10.1016/0002-9149(88)91294-5 |
ISSN: | 0002-9149 |
DOI: | 10.1016/0002-9149(88)91294-5 |
Popis: | Reperfusion of ischemic myocardium has been reported to increase the cumulative creatine kinase activity in plasma per gram of infarcted myocardium as assessed with the method of Shell et al. In an attempt to find out whether infarct size assessment using the method of Witteveen et al was affected by reperfusion, the relation between enzymatic infarct size was analyzed using Witteveen's method and left ventricular (LV) function parameters in 266 patients with first acute myocardial infarction randomized to intracoronary thrombolysis (n = 134) or conventional therapy (n = 132). Compared with patients allocated to conventional therapy, patients allocated to intracoronary thrombolysis had smaller enzymatic infarct size by 29% (p less than 0.001), smaller LV end-diastolic and end-systolic volume indexes by 10% (p less than 0.05) and 20% (p less than 0.005), respectively, and higher LV ejection fraction (55 +/- 1% vs 49 +/- 1%; p less than 0.001). The beneficial effects of thrombolytic therapy on LV performance were closely associated with thrombolysis-induced limitation of infarct size. The dependence from infarct size of LV end-diastolic volume, LV end-systolic volume, and ejection fraction was not different in the 2 therapy groups. It was concluded that Witteveen's method of infarct size assessment is not influenced by the presence of reperfusion. Therefore, this method was recommended for trials on recanalization in patients with acute myocardial infarction. |
Databáze: | OpenAIRE |
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