Frequency and significance of right ventricular dysfunction during inferior wall left ventricular myocardial infarction treated with thrombolytic therapy (results from the Thrombolysis in Myocardial Infarction [TIMI] II trial)
Autor: | Barry L. Zaret, Thomas J. Ryan, David P. Faxon, Nicholas A. Ruocco, Margaret Frederick, Alice K. Jacobs, Peter B. Berger, Frans J. Th. Wackers |
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Rok vydání: | 1993 |
Předmět: |
Male
medicine.medical_specialty Heart Diseases Heart Ventricles medicine.medical_treatment Adrenergic beta-Antagonists Myocardial Infarction Radionuclide ventriculography Constriction Pathologic Ventricular Function Left Constriction Internal medicine Angioplasty medicine Humans Thrombolytic Therapy Myocardial infarction Angioplasty Balloon Coronary Radionuclide Ventriculography Ejection fraction business.industry Thrombolysis Middle Aged medicine.disease Combined Modality Therapy Coronary Vessels medicine.anatomical_structure Tissue Plasminogen Activator Ventricular Function Right Cardiology Female Cardiology and Cardiovascular Medicine business TIMI Artery |
Zdroj: | The American Journal of Cardiology. 71:1148-1152 |
ISSN: | 0002-9149 |
Popis: | To determine the effect of thrombolytic therapy on the frequency of right ventricular (RV) dysfunction, and whether RV dysfunction is a risk factor for morbidity and mortality after discharge from the hospital, 1,110 patients in the Thrombolysis in Myocardial Infarction (TIMI) II trial with acute inferior wall left ventricular myocardial infarction were studied. RV dysfunction was defined as an RV wall motion abnormality on equilibrium radionuclide ventriculography performed a mean of 9 days after admission to the hospital. Fifty-eight patients (5%) had RV dysfunction. Baseline clinical characteristics among patients with and without RV dysfunction were similar. However, patients with RV dysfunction had a lower mean left ventricular ejection fraction (51.2 +/- 1.2% vs 55.5 +/- 0.3%; p < 0.001) and a greater frequency of in-hospital complications. Angiographic data from patients undergoing protocol catheterization 18 to 48 hours after hospital admission show that the infarct-related artery was more likely to be occluded in those with RV dysfunction (48% [15 of 31] vs 14% [68 of 495]; p < 0.001). There was no difference in the frequency of multivessel disease between the 2 groups. In patients with RV dysfunction in whom radionuclide ventriculography was repeated 6 weeks after hospital discharge, RV wall motion abnormalities persisted in only 18% (8 of 45). Mortality in the year after discharge was 3.5% (2 of 58) among patients with RV dysfunction compared with 1.7% (18 of 1,052; p = NS) among those without RV dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS) |
Databáze: | OpenAIRE |
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