Late reperfusion for acute myocardial infarction limits the dilatation of left ventricle without the reduction of infarct size.

Hirayama, Atsushi; Adachi, Takahiro; Asada, Shinji; Mishima, Masayoshi; Nanto, Shinsuke; Kusuoka, Hideo; Yamamoto, Kazuhiro; Matsumura, Yasushi; Hori, Masatsugu; Inoue, Michitoshi

doi:10.1161/01.cir.88.6.2565

Cited by 82 publications

(36 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The infarct sizes estimated from the peak MLC1 level were similar between the groups. These results are consistent with previous reports 24 of the open artery hypothesis that late reperfusion could prevent LV remodeling after the onset of AMI, whereas infarct size is not preserved.…”

Section: Possible Mechanisms Of Beneficial Effects Of Late Reperfusionsupporting

confidence: 93%

Long-Term Beneficial Effect of Late Reperfusion for Acute Anterior Myocardial Infarction With Percutaneous Transluminal Coronary Angioplasty

et al. 1998

View full text Add to dashboard Cite

Background-Although the short-term and long-term beneficial effects of early coronary revascularization by primary PTCA or thrombolytic therapy have been established for acute myocardial infarction, thrombolytic therapy Ͼ24 hours after the onset of acute myocardial infarction has not been shown to improve clinical outcome. The purpose of this study was to assess the effect of late revascularization by primary PTCA over a 5-year period. Methods and Results-Eighty-three patients with initial Q-wave anterior myocardial infarction Ͼ24 hours after onset were randomized into a PTCA group (nϭ44) and a no-PTCA group (nϭ39). Long-term follow-up was conducted with regard to end points, which included cardiac death, nonfatal recurrence of myocardial infarction, and development of congestive heart failure. Left ventricular ejection fraction and regional wall motion at 6 months after myocardial infarction were similar in the 2 groups. Left ventricular end-diastolic and end-systolic volume indexes were significantly smaller in the PTCA group than in the no-PTCA group (PϽ0.0001). With cardiac events as end points, a 5-year Kaplan-Meier event-free survival analysis revealed that the no-PTCA group had a worse prognosis than the PTCA group (PϽ0.0001). Patency of the infarct-related artery, left ventricular ejection fraction, end-diastolic volume index, and end-systolic volume index were significantly associated with cardiac events by a Cox proportional hazards analysis (hazard ratios 0.120, 0.845, 1.065, and 1.164, respectively). Conclusions-In initial Q-wave anterior myocardial infarction, we conclude that even with late reperfusion, PTCA had beneficial effects on cardiac events over the 5-year period after myocardial infarction, with the prevention of left ventricular dilation after myocardial infarction being a possible mechanism. (Circulation. 1998;98:2377-2382.)

show abstract

Section: Possible Mechanisms Of Beneficial Effects Of Late Reperfusionsupporting

confidence: 93%

Long-Term Beneficial Effect of Late Reperfusion for Acute Anterior Myocardial Infarction With Percutaneous Transluminal Coronary Angioplasty

et al. 1998

View full text Add to dashboard Cite

show abstract

“…26) Reperfusion prevents left ventricle dilatation, even if it is relatively delayed (achieved within > 4 to 6 hours). 27) In our study, statistically significant changes were found in group A patients only in the period between discharge and day 30 from randomisation. The EDD did not change significantly in groups B and C until the 6-month check-up.…”

Section: Discussionmentioning

confidence: 38%

“…24) It begins very early after MI, reaches a maximum rate within 14 days, and persists at a slower rate for at least 6-12 months, and probably longer. [24][25][26][27] Left ventricle end-diastolic dimension is an indicator of left ventricle remodelling. Both end-diastolic and end-systolic dimensions increase after myocardial infarction but, with reperfusion, the left ventricle dimension demonstrates a lower rate of increase.…”

Section: Discussionmentioning

confidence: 99%

Inter-hospital Transport for Primary Angioplasty Does Not Compromise Left Ventricular Function

et al. 2003

View full text Add to dashboard Cite

SUMMARYThe main aim of the present study was to investigate whether long distance interhospital transport for primary angioplasty (delayed mechanical reperfusion) influences the resulting left ventricular function after myocardial infarction as compared with thrombolysis at the nearest hospital (immediate pharmacological reperfusion).Primary coronary angioplasty is more effective than thrombolysis in restoring coronary flow in patients with acute myocardial infarction. It is not known whether a delay in reperfusion due to transport to an angioplasty centre compromises left ventricular function, and whether combination therapy (ie, thrombolysis during transport to an angioplasty centre) would help preserve ejection fraction.The "PRAGUE-1" Study randomised 300 patients with myocardial infarction admitted to community hospitals without a cath-lab into 3 groups: group A (thrombolysis, no transport, n = 99), group B (thrombolysis during transport to an angioplasty centre, n = 100), and group C (transport for primary angioplasty, n = 101). Transport distances were below 75 kilometres, and mean transport time was 38 minutes. This paper presents for the first time the echocardiographic data from the early (discharge, day 30) and mid-term (6 months) follow-up. Only patients who survived until discharge (A: 85, B: 88, C: 94) could be analysed.Ejection fraction improved between discharge and 6 months (P < 0.01) in all three groups: from 47% to 51% in group A, from 47% to 52% in group B, and from 48% to 52% in group C. The differences between the groups were not significant. The same differences were found for the wall motion score index. Left ventricular end-diastolic diameter did not differ between the groups/examinations. Greater improvement was documented in the period between hospital discharge and day 30, compared to the period between day 30 and 6 months.The time delay associated with an inter-hospital transport strategy for primary angioplasty did not compromise left ventricular function. The strategy of thrombolysis during transport did not further improve left ventricular function compared to transport for priFrom

show abstract

“…Previous studies have demonstrated that infarct-related artery patency is an important determinant of ventricular remodeling after AMI. 19,20 In the current study, the incidence of TIMI grade 3 at follow-up did not differ between the 2 groups. In addition, it is noteworthy that the use of medications, such as nitrates 21 and ACEI, which might prevent ventricular remodeling after AMI, were similar between the 2 groups.…”

Section: Ventricular Functionmentioning

confidence: 42%

Effect of Intraaortic Balloon Pumping on Left Ventricular Function in Patients With Persistent ST Segment Elevation After Revascularization for Acute Myocardial Infarction.

Kurisu

Inoue

Kawagoe

et al. 2003

Circ J

View full text Add to dashboard Cite

n acute myocardial infarction (AMI), early, complete and sustained restoration of blood flow in the occluded coronary artery can salvage myocardium at risk and improve survival. 1 Revascularization of the occluded coronary artery with balloon angioplasty can be achieved in >90% of patients. 2 However, even early restoration of thrombolysis-in-myocardial-infarction (TIMI) grade 3 flow is not always associated with myocardial reperfusion because of microvascular damage. [3][4][5][6][7] Recent studies have demonstrated that persistent ST segment elevation after revascularization is a marker of impaired microvascular reperfusion 8 and is associated with a worse clinical outcome. [9][10][11][12] Intraaortic balloon pumping (IABP), which can reduce the rate of infarct-related artery reocclusion, augment myocardial recovery and improve clinical outcome after AMI, 13,14 would be expected to be most effective in AMI patients with persistent ST segment elevation after revascularization.This study was undertaken to assess the impact of IABP on left ventricular function in AMI patients with persistent ST segment elevation after revascularization. Methods Study PopulationBetween January ented with a first anterior AMI and underwent emergency coronary angiography within 6 h of the onset of chest pain. The data relating to these patients were prospectively entered into a computer database, and from this we selected 51 patients who met the following criteria: (1) ischemic chest pain lasting for >30 min; (2) ST segment elevation of at least 0.2 mV in 2 or more contiguous electrocardiographic (ECG) leads; (3) elevation of serum creatine kinase concentration to more than twice the normal upper limit; (4) total occlusion (TIMI grade 0 or 1) of the proximal left The purpose of the present study was to assess the impact of intraaortic balloon pumping (IABP) in patients with persistent ST elevation who underwent revascularization within 6 h of their first acute anterior myocardial infarction (AMI). Persistent ST elevation after revascularization was defined as being ≥50% of the initial value on return to the coronary care unit. Twenty-four patients were treated without IABP (control group) and 27 patients were treated with IABP (IABP group). There was no significant difference between the 2 groups in pretreatment left ventricular ejection fraction (LVEF), end-diastolic volume index or end-systolic volume index. After 137±46 days, the change in the LVEF was significantly higher in the IABP group than in the control group (5±13% vs 13±15%, p=0.04). However, the left ventricular end-diastolic volume index was similar between the 2 groups during follow-up (pretreatment: 77±19 ml/m 2 vs 74±13 ml/m 2 , p=0.54; follow-up: 86±22 ml/m 2 vs 83±18 ml/m 2 , p=0.60). These data suggest that IABP enhances the improvement in LVEF independent of remodeling in AMI patients with persistent ST elevation after revascularization.

show abstract

Late reperfusion for acute myocardial infarction limits the dilatation of left ventricle without the reduction of infarct size.

Abstract: Late reperfusion appeared to prevent ventricular dilatation acute myocardial infarction independent of the limitation of infarct size.

Cited by 82 publications

References 56 publications

Long-Term Beneficial Effect of Late Reperfusion for Acute Anterior Myocardial Infarction With Percutaneous Transluminal Coronary Angioplasty

Long-Term Beneficial Effect of Late Reperfusion for Acute Anterior Myocardial Infarction With Percutaneous Transluminal Coronary Angioplasty

Inter-hospital Transport for Primary Angioplasty Does Not Compromise Left Ventricular Function

Effect of Intraaortic Balloon Pumping on Left Ventricular Function in Patients With Persistent ST Segment Elevation After Revascularization for Acute Myocardial Infarction.

Contact Info

Product

Resources

About