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Titolo:
COLLATERAL CHANNELS THAT DEVELOP AFTER AN ACUTE MYOCARDIAL-INFARCTIONPREVENT SUBSEQUENT LEFT-VENTRICULAR DILATION
Autore:
KODAMA K; KUSUOKA H; SAKAI A; ADACHI T; HASEGAWA S; UEDA Y; MISHIMA M; HORI M; KAMADA T; INOUE M; HIRAYAMA A;
Indirizzi:
OSAKA POLICE HOSP,DIV CARDIOVASC,TENNOJI KU,10-31 KITAYAMA CHO OSAKA 543 JAPAN OSAKA POLICE HOSP,DIV CARDIOVASC,TENNOJI KU OSAKA 543 JAPAN OSAKA UNIV,SCH MED,DEPT INTERNAL MED OSAKA JAPAN OSAKA UNIV,SCH MED,DEPT MED INFORMAT SCI OSAKA JAPAN
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 5, volume: 27, anno: 1996,
pagine: 1133 - 1139
SICI:
0735-1097(1996)27:5<1133:CCTDAA>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
UNIVERSITY REPERFUSION TRIAL; CORONARY-ARTERY; THROMBOLYTIC THERAPY; ANEURYSM FORMATION; BLOOD-FLOW; CIRCULATION; OCCLUSION; SURVIVAL; DYSFUNCTION; SIZE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
35
Recensione:
Indirizzi per estratti:
Citazione:
K. Kodama et al., "COLLATERAL CHANNELS THAT DEVELOP AFTER AN ACUTE MYOCARDIAL-INFARCTIONPREVENT SUBSEQUENT LEFT-VENTRICULAR DILATION", Journal of the American College of Cardiology, 27(5), 1996, pp. 1133-1139

Abstract

Objectives. We sought to evaluate the effect of collateral chan nels that develop late after a first anterior myocardial infarction on leftventricular dilation and function. Background. Collateral channels inan infarct-related artery may develop long after occlusion of the artery. Well visualized collateral channels that appear immediately aftera myocardial infarction reduce infarct size and preserve left ventricular function. However, the functional significance of collateral channels that develop late after myocardial infarction has not been evaluated in terms of left ventricular function. Methods. We studied 21 patients with a first anterior myocardial infarction and an infarct-related artery that remained totally occluded after reperfusion therapy and did not reopen within 1 month of infarction. No collateral channels were observed during the acute period. Patients were classified into twogroups according to the extent of collateral formation 1 month after infarction: group C, patients with well developed collateral channels (n = 11), and group NC, patients with absent or poorly developed collateral channels (n = 10). Infarct size was determined by peak creatine kinase activity and thallium-201 single-photon emission computed tomography. Global and regional left ventricular function and left ventricular volumes were assessed by left ventriculography. These measurementswere identical in both groups 1 month after infarction. Left ventricular function was reevaluated after 2.12 +/- 0.79 years (mean +/- SD). Results. There were no significant changes in global and regional leftventricular function between the two groups during the long term follow-up period, However, the end-diastolic volume index of group NC increased from 71 +/- 14 to 85 +/- 19 ml/m(2), whereas that of group C decreased from 64 +/- 18 to 59 +/- 12 ml/m(2). This important change during the long term follow-up period resulted in a significant difference(p = 0.006) in the end-diastolic volume index between the groups 2 years after onset (p = 0.002), whereas 1 month after infarction the difference was not significant (p = 0.36). A similar pattern was observed for the end-systolic volume index (group C: 38 +/- 16 to 35 +/- 14 ml/m(2); group NC: 45 +/- 12 to 58 +/- 18 ml/m(2), p = 0.018). The power of the tests to detect the observed differences showing nonsignificantresults ranged from 0.05 to 0.38, whereas the power of the tests indicating a significant difference in end diastolic and end-systolic volume indexes was >0.88. Conclusions. Collateral channels that develop after a myocardial infarction do not reduce the infarct size or prevent left ventricular dilation within 1 month of infarction. In contrast, such collateral channels prevent subsequent ventricular dilation and the deterioration of left ventricular function over 2 years. How ever, our results may have been biased because of the small number of patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/09/20 alle ore 20:10:50