Abstract
The use of early coronary angiography to assess the benefits of coronary patency on left ventricular size and function fails to account for subsequent reocclusion or spontaneous reperfusion. To investigate the relationship between late vessel patency and changes in left ventricular structure and function after thrombolysis, echocardiography was performed within 48 hours and at 6 to 12 weeks in 30 patients treated with intravenous thrombolysis. Left ventricular endocardial surface area index (ESA i; cm 2/m 2) and extent of abnormal wall motion were quantitated in those with a patent ( n = 20) and those with an occluded ( n = 10) infarct-related artery on coronary angiography performed 8 ± 6 days after thrombolysis. Mean ESA i increased from (53 ± 7 to 61 ± 10 cm 2/m 2; p < 0.02) in the occluded group during the follow-up period but remained unchanged (60 ± 11 to 62 ± 11 cm 2/m 2; p = NS) in the patent group. Mean percentage of abnormal wall motion decreased in the patent group (27 ± 16% to 18 ± 16%; p < 0.01), whereas no significant change was noted in the occluded group (20 ± 13% to 23 ± 17%; p = NS). Thus coronary patency at days after thrombolysis is associated with both improvement in regional left ventricular function and attentuated left ventricular dilatation.
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