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Titolo:
REPERFUSION REDUCES LEFT-VENTRICULAR DILATATION BY PREVENTING INFARCTEXPANSION IN THE ACUTE AND CHRONIC PHASES OF MYOCARDIAL-INFARCTION
Autore:
GOLIA G; MARINO P; RAMETTA F; NIDASIO GP; PRIOLI MA; ANSELMI M; DESTRO G; ZARDINI P;
Indirizzi:
UNIV VERONA,CATTEDRA CLIN CARDIOL,ECOCARDIOGRAFIA LAB,P STEFANI 1 I-37126 VERONA ITALY
Titolo Testata:
The American heart journal
fascicolo: 3, volume: 127, anno: 1994,
pagine: 499 - 509
SICI:
0002-8703(1994)127:3<499:RRLDBP>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
TWO-DIMENSIONAL ECHOCARDIOGRAPHY; CORONARY COLLATERAL CIRCULATION; THROMBOLYTIC THERAPY; CREATINE-KINASE; INTRAVENOUS STREPTOKINASE; CONVENTIONAL TREATMENT; PLASMINOGEN-ACTIVATOR; REGIONAL ISCHEMIA; SIZE; VOLUME;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
64
Recensione:
Indirizzi per estratti:
Citazione:
G. Golia et al., "REPERFUSION REDUCES LEFT-VENTRICULAR DILATATION BY PREVENTING INFARCTEXPANSION IN THE ACUTE AND CHRONIC PHASES OF MYOCARDIAL-INFARCTION", The American heart journal, 127(3), 1994, pp. 499-509

Abstract

Reperfusion reduces left ventricular dilatation in patients with acute myocardial infarction, but it is unclear to what extent this is a primary effect or only a consequence of the limiting effect of reperfusion on infarct size. To address this issue, 56 consecutive patients were examined by means of two-dimensional echocardiography on day 1, on day 3, before discharge, and at 6 months after an acute myocardial infarction. From this population two groups of 12 patients each, perfectlymatched for site of myocardial infarction, extent of ventricular asynergy at two-dimensional echocardiography (akinesis + dyskinesis), and clinical characteristics were identified according to the creatine kinase (CK) time to peak, which was regarded as a marker of spontaneous or induced reperfusion: (1) CK time to peak of 12 hours or less (reperfused patients, n = 12), and (2) CK time to peak of more than 12 hours (nonreperfused patients, n = 12). In these two groups of patients end-diastolic and end-systolic left ventricular volumes and endocardial lengths of asynergic and normal ventricular segments, imaged in a cross-sectional view at the level of the papillary muscles, were then computed. At the first examination end-diastoIic volume, end-systolic volume, and endocardial segment lengths of normal and asynergic segments were similar in the two groups of patients. Patients with late CK time topeak, however, showed a progressive increase in left ventricular systolic volumes and in asynergic endocardial segment lengths between the first and third (predischarge) examinations (p < 0.05 for both), with no change in systolic length of the normal myocardium. The left ventricular end-systolic volume and the asynergic endocardial segment lengthof patients with early CK time to peak, however, did not increase during hospitalization. The increment in end-systolic volume and in systolic infarct segment length from the first to the third examinations was higher in nonreperfused patients (p = 0.018 and p = 0.04, respectively). Changes similar to those detected in systole were found for diastolic volume and diastolic infarcted and noninfarcted segment length inboth groups, but they did not reach statistical significance. After 6months, an increases in volume and endocardial length were found in both groups of patients. Relative to the first examination, however, the increase in systolic volume and in asynergic systolic endocardial lengths remained greater for nonreperfused patients (p = 0.077 and p = 0.01, respectively). In conclusion, reperfusion after myocardial infarction prevents ventricular dilatation by inhibiting infarct expansion during the in-hospital phase of the illness, above and beyond its limiting effect on infarct size. The difference generated in the acute phase is maintained during the 6-month follow-up period, in which increases in volume and in endocardial segment length affect both reperfused and nonreperfused patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 23:04:35