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Titolo:
Full recovery of contraction late after acute myocardial infarction: determinants and early predictors
Autore:
Lancellotti, P; Albert, A; Berthe, C; Pierard, LA;
Indirizzi:
Univ Hosp Liege, Div Cardiol, B-4000 Liege, Belgium Univ Hosp Liege Liege Belgium B-4000 Div Cardiol, B-4000 Liege, Belgium Univ Hosp Liege, Dept Biostat, B-4000 Liege, Belgium Univ Hosp Liege Liege Belgium B-4000 Dept Biostat, B-4000 Liege, Belgium
Titolo Testata:
HEART
fascicolo: 5, volume: 85, anno: 2001,
pagine: 521 - 526
SICI:
1355-6037(200105)85:5<521:FROCLA>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR FUNCTION; DOBUTAMINE STRESS ECHOCARDIOGRAPHY; TWO-DIMENSIONAL ECHOCARDIOGRAPHY; CORONARY ANGIOPLASTY; THROMBOLYTIC THERAPY; ANTERIOR INFARCTION; STUNNED MYOCARDIUM; VIABLE MYOCARDIUM; CREATINE-KINASE; WALL MOTION;
Keywords:
myocardial infarction; echocardiography; prognosis; angioplasty;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Pierard, LA Univ Hosp Liege, Div Cardiol, B-4000 Liege, Belgium Univ Hosp Liege Liege Belgium B-4000 , B-4000 Liege, Belgium
Citazione:
P. Lancellotti et al., "Full recovery of contraction late after acute myocardial infarction: determinants and early predictors", HEART, 85(5), 2001, pp. 521-526

Abstract

Objectives--To assess the relative value of electrocardiographic, echocardiographic, angiographic, and in-hospital therapeutic indices for predictinglate functional recovery after acute myocardial infarction, and to determine the variables associated with absence of recovery, partial recovery, andfull recovery. Design--Prospective observational follow up study. Setting--Teaching hospital. Patients--74 consecutive patients with a first uncomplicated acute myocardial infarct. Interventions-Dobutamine-atropine stress echocardiography was performed mean (SD) 5 (2) days after the acute event. Quantitative angiography was available in all patients before hospital discharge. A follow up resting echocardiogram was obtained 12 (2) months later. Results--Functional recovery (partial, n = 18; full, n = 27) was observed in 45 of the 74 patients. Recovery was associated with earlier thrombolytictreatment (p = 0.008), earlier peak concentration of creatine kinase (p = 0.009), greater contractile reserve (p = 0.0001), non-Q wave acute myocardial infarction (p 0.002), and more frequent elective angioplasty of the infarct related vessel (p = 0.0004). Three independent variables were selected stepwise from multivariate analysis for predicting late recovery: contractile reserve (chi (2) = 24.2, p < 0.0001); non-Q wave infarction (chi (2) = 15.7, p = 0.0001); and the time from symptom onset to thrombolysis (chi (2) = 4.94, p = 0.026). Three independent variables predicted full recovery: contractile reserve (chi (2) = 17.2, p = 0.0001); non-Q wave infarction (chi (2) = 10.1, p = 0.0016); and elective angioplasty of the infarct related artery (chi (2) = 4.53, p = 0.013). Only contractile reserve (chi (2) = 17.0,p < 0.001) was selected from the multivariate analysis for its ability to distinguish between partial recovery and absence of recovery. Conclusions--Late recovery of contraction relates to earlier treatment, which is associated with lower infarct size unmasked by a non-Q wave event and the presence of contractile reserve. Elective coronary angioplasty of theinfarct related artery before hospital discharge is associated with full recovery.

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Documento generato il 25/01/20 alle ore 18:42:34