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Early recovery of regional left ventricular function after reperfusion in acute myocardial infarction assessed by serial two-dimensional echocardiography
Ist Teil von
The American journal of cardiology, 1989-03, Vol.63 (11), p.641-646
Ort / Verlag
New York, NY: Elsevier Inc
Erscheinungsjahr
1989
Quelle
Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)
Beschreibungen/Notizen
Although global and regional left ventricular (LV) function has been demonstrated to improve after reperfusion in acute myocardial infarction (AMI), the timing of these changes has not been well established. In this study, serial 2-dimensional echocardiography was used to assess regional LV function in 23 patients with AMI in whom reperfusion was accomplished by thrombolysis alone, by coronary angioplasty alone or by both interventions within 6 hours after onset of chest pain. Echocardiograms were performed before or within 6 hours after reperfusion (n = 23) and at 1 (n = 19), 3 (n = 21) and 7 (n = 20) days after reperfusion. Wall motion index and percentage of normally functioning muscle were calculated using a 16-segment scoring system analyzed in blinded fashion without knowledge of patient identity, therapy or time of study. The mean wall motion index improved from 1.78 ± 0.48 to 1.56 ± 0.38 at 1 day (n = 19, p < 0.01), and to 1.48 ± 0.37 at 3–7 days (p < 0.01), with no significant difference between 3 days (1.49 ± 0.39) and 7 days (1.42 ± 0.30). There was a corresponding improvement in the percentage of normally functioning muscle, from 53 ± 24% at 6 hours to 62 ± 20% at 1 day (p < 0.05) and to 67 ± 18% at 3–7 days (p < 0.01), again with no significant difference between 3 days (67 ± 21) and 7 days (70 ± 20). The data indicate that in many patients with AMI and successful reperfusion there was a rapid improvement in LV wall motion abnormalities, often within 24 hours. In most patients maximal improvement was seen within 3 days.