Changes of global and regional left-ventricular function by reperfusion in acute myocardial infarction
Tebbe, U.; Sauer, G.; Kreuzer, H.; Neuhaus, K.L.
Zeitschrift für Kardiologie 71(10): 656-660
1982
ISSN/ISBN: 0300-5860 PMID: 7157919 Document Number: 194195
Biplane ventriculography was performed during the acute and chronic stage (3 wk) of myocardial infarction in 54 patients. Early recanalization was attempted by i.v. streptokinase in 33, by intracoronary streptokinase in 15 and by catheter manipulation in 6 patients. In patients with successful recanalization (n = 37), biplane LV ejection fraction (EFbi) increased slightly from 53 .+-. 10 to 56 .+-. 9% on average; with late recanalization or permanent occlusion, EFbi decreased significantly from 47 .+-. 11 to 39 .+-. 8% (P < 0.001). Correspondingly, the akinetic segment length (AKS) and the number of akinetic radians (Sak) (semiautomated system) decreased with early recanalization and increased with permanent occlusion. Comparing global and regional LV function, EF and Ssk correlated closely (r = 0.81), while EF and AKS revealed only a loose correlation (r = 0.59). Biplane and RAO single-plane EF correlated with an r-value of 0.88; Sy,x, however, was 9.9%. There was a considerable scatter in the relation between the parameters of regional wall motion, AKS and Ssk (r = 0.80; Sy,x = 10.6). On average, there is a slight improvement in LV function after successful early reperfusion, which seems to be independent of the method of recanalization. Changes of regional akinesis after reperfusion cannot be assessed accurately by angiography.