Early recovery of regional left ventricular function after reperfusion in acute myocardial infarction assessed by serial two-dimensional echocardiography

Bourdillon, Patrick D.V.; Broderick, Thomas M.; Williams, Eric S.; Davis, Cris; Dillon, James C.; Armstrong, William F.; Fineberg, Naomi S.; Ryan, Thomas J.; Feigenbaum, Harvey

doi:10.1016/0002-9149(89)90243-9

Cited by 67 publications

(20 citation statements)

References 13 publications

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“…Global and regional LV function improves after successful PCI. [15][16][17] Therefore, complications after AMI may be best predicted by functional indices after the PCI. However, earlier prediction is clinically important and functional indices before the PCI can potentially express spatial extension of ischemia and the degree of pre-PCI reperfusion, which is a significant determinant of post-PCI cardiac function.…”

Section: Prediction Of Complications With Ami By the Tei Indexmentioning

confidence: 99%

Noninvasive prediction of complications with anteroseptal acute myocardial infarction by left ventricular Tei index

Yuasa

Kuwahara

Takasaki

et al. 2005

Journal of the American Society of Echocardiography

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Section: Prediction Of Complications With Ami By the Tei Indexmentioning

confidence: 99%

Noninvasive prediction of complications with anteroseptal acute myocardial infarction by left ventricular Tei index

Yuasa

Kuwahara

Takasaki

et al. 2005

Journal of the American Society of Echocardiography

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“…Especially following farmacological or mechanical restoration of coronary flow, improvement of wall motion may be seen during the post acute period [22,23]. Functional improvement of salvaged myocardium, however, is time dependent, due to delayed restoration of contraction of stunned post-ischaemic myocardium [24]. Since early count density index is related to the ultimate degree of asynergy, a low value for count density index is capable to recognize patients who will exhibit wall motion improvement in the post-acute phase, as we reported recently [9].…”

Section: Discussionmentioning

confidence: 99%

Early Indium-111 antimyosin scintigraphy for assessment of regional wall motion asynergy on discharge after myocardial infarction

et al. 1990

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To assess the relation between early Indium-111 monoclonal antimyosin antibody scintigraphy and degree of regional asynergy on discharge, 38 patients with a first acute myocardial infarct were studied (18 anterior, 20 inferoposterior infarctions). In 21 patients thrombolytic therapy was administered. On the first day of myocardial infarction, 80 MBq Indium-111 Antimyosin was injected. Planar images, anterior, lateral and left anterior oblique, were made 24 hours later. Localized myocardial uptake was present in 37/38 patients, and was evaluated for Count Density Index (count density of infarct zone/left lung count density) in the left anterior oblique images, which displayed the infarct zone well. Regional asynergy on discharge was evaluated by cross-sectional echocardiography and defined mild (hypokinesia) or severe (akinesia or dyskinesia). Count density index was significantly lower in 15 patients with mild asynergy, compared with 22 patients with severe asynergy (1.61 +/- 0.25 vs. 2.42 +/- 0.40, p less than 0.001). This difference was present in both patient groups treated with or without thrombolysis. We conclude that early count density index, reflecting the amount of local necrosis, is highly correlated to the ultimate degree of wall motion impairment.

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“…22,23 When that occurs, the global LV systolic function does not improve immediately after reperfusion, instead it is deferred for a few days 24 or some months, 25,26 a condition that is known as stunned myocardium. 27 The delayed improvement depends on several factors, such as the duration of ischemia before reperfusion, the degree of perfusion by means of collateral vessels, the severity of residual coronary stenosis after PCI, and the extent of the ischemic region.…”

Section: Predictors Of Long-term Clinical Outcome In Patientsmentioning

confidence: 99%

“…27 The delayed improvement depends on several factors, such as the duration of ischemia before reperfusion, the degree of perfusion by means of collateral vessels, the severity of residual coronary stenosis after PCI, and the extent of the ischemic region. 24,28 In this setting, LVEF and LVWMSI, which are strong predictors of an adverse outcome, cannot predict the outcome because of the stunned myocardium and/or the compensatory hyperkinesia of the undamaged myocardium. In the present study, the echocardiographic LVEF and LVWMSI showed a strong prognostic significance in the univariate analysis, but it was lost in the multivariate logical regression analysis, and instead LVDd (dilated) and impaired LV diastolic function (PN) at discharge were recognized as the most powerful predictors of a subsequent event.…”

Section: Predictors Of Long-term Clinical Outcome In Patientsmentioning

confidence: 99%

Echocardiographic Predictors of Remote Outcome in Patients With Angiographically Successful Reflow After Acute Myocardial Infarction

Liu

Tanaka

Murata

et al. 2004

Circ J

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ercutaneous coronary intervention (PCI) is now routine for patients with acute myocardial infarction (AMI), and is increasingly used to treat complex coronary lesions with good long-term outcome. However, in the multicenter Lescol Intervention Prevention Study, 1 the annual risk of a major adverse cardiac event, defined as cardiac death, nonfatal myocardial infarction (MI) or a reintervention procedure (eg, coronary artery bypass grafting (CABG), repeat PCI, or PCI for a new lesion) approached 7%.Early restoration of coronary antegrade flow limits the progression of myocardial necrosis and is thus expected to enhance the functional recovery of postischemic dysfunction of the myocardium in patients with AMI. [2][3][4] Previous studies have demonstrated that 'angiographic no-reflow' predicts poor left ventricular (LV) functional recovery and a higher risk of cardiac mortality during the early phase and long-term follow-up period in patients with AMI. 5,6 However, the long-term prognosis after AMI remains unexplored in patients with angiographically successful reflow (TIMI (Thrombolysis in Myocardial Infarction) flow grade 3) after PCI.Several recent studies have proved the clinical usefulness of echocardiography in predicting outcome in patients with congestive heart failure (CHF), 7 AMI 8 and CABG, 9 but its long-term prognostic value in patients with angiographically successful reflow after AMI is unknown. Thus, in the present study we analyzed the long-term prognostic value of echocardiography in a consecutive series of patients with complete coronary revascularization by primary PCI for an initial AMI. Methods Patient PopulationOf 168 consecutive patients with AMI who were treated at Yamaguchi University Hospital, Japan, between January 1995 and January 2000, 113 (82 men, 31 women; age 46-84 years) were enrolled in the study. Criteria for inclusion were: (1) initial AMI; (2) a single-culprit lesion; (3) the infarct-related artery was recanalized with direct or rescue-PCI within 6 h of onset or between 6 and 24 h if evidence showed continuing ischemia; (4) residual stenosis Background The angiographically no-reflow phenomenon after percutaneous coronary intervention (PCI) predicts poor left ventricular (LV) functional recovery and a high risk of cardiac events in patients with their first acute myocardial infarction (AMI). However, risk factors of long-term adverse outcome for patients with angiographically successful reflow (TIMI (Thrombolysis in Myocardial Infarction) flow grade 3) for the AMI remain unknown. Methods and ResultsOf 168 echocardiograms were performed before PCI and at discharge, 113 were suitable for analysis. Clinical, angiographic, and echocardiographic variables were submitted to statistical analysis to detect the risk factors of cardiac events. During the follow-up period of 46±20 months, 31 patients had cardiac events, though there were no cardiac deaths. The 2 most important risk factors for congestive heart failure (CHF) or total cardiac events were LV dilation (chi-square: 7.5 and 9.4; ...

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Early recovery of regional left ventricular function after reperfusion in acute myocardial infarction assessed by serial two-dimensional echocardiography

Cited by 67 publications

References 13 publications

Noninvasive prediction of complications with anteroseptal acute myocardial infarction by left ventricular Tei index

Noninvasive prediction of complications with anteroseptal acute myocardial infarction by left ventricular Tei index

Early Indium-111 antimyosin scintigraphy for assessment of regional wall motion asynergy on discharge after myocardial infarction

Echocardiographic Predictors of Remote Outcome in Patients With Angiographically Successful Reflow After Acute Myocardial Infarction

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