Comparison of regional and global left ventricular function by serial echocardiograms after reperfusion in acute myocardial infarction.

T. M. Broderick, P. D. Bourdillon, T. Ryan, Harvey Feigenbaum, J. C. Dillon, W. F. Armstrong

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Abstract

Fifty patients undergoing successful reperfusion therapy (percutaneous transluminal coronary angioplasty 20, thrombolysis 10, combined 20) for acute myocardial infarction were evaluated with serial two-dimensional echocardiograms performed early (less than 24 hours, mean 8 hours) and late (greater than 3 days, mean 6 days) after presentation. Treatment occurred within 12 hours of the onset of symptoms with most patients achieving reperfusion in less than 6 hours (mean 4.7 hours) from the onset of pain. Reperfusion was demonstrated short-term by angiography in 42 of 50 patients (84%). Four patients had clinical signs of reperfusion and subsequent angiographic confirmation. An additional four patients with "stuttering" infarct courses were treated late by percutaneous transluminal coronary angioplasty. Echocardiograms were analyzed for global performance by calculation of fractional area change at the papillary muscle level and ejection fraction (biplane Simpson's rule) in 18 patients in whom this analysis could be performed. Measurements of regional function included fractional shortening at the base (n = 37), regional wall motion index (n = 50) and percent of normal functioning myocardium (n = 50). Overall there was a significant improvement in regional wall scores and percent of functioning myocardium (regional wall motion index 1.73 to 1.43, p less than 0.001 and percent of functioning myocardium 0.61 to 0.70, p less than 0.001) but only a trend toward improvement when global function was assessed by ejection fraction (0.42 to 0.48, p less than 0.14).(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish
Pages (from-to)315-323
Number of pages9
JournalJournal of the American Society of Echocardiography
Volume2
Issue number5
StatePublished - Sep 1989

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Left Ventricular Function
Reperfusion
Myocardial Infarction
Myocardium
Coronary Balloon Angioplasty
Stuttering
Papillary Muscles
Angiography
Pain
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of regional and global left ventricular function by serial echocardiograms after reperfusion in acute myocardial infarction. / Broderick, T. M.; Bourdillon, P. D.; Ryan, T.; Feigenbaum, Harvey; Dillon, J. C.; Armstrong, W. F.

In: Journal of the American Society of Echocardiography, Vol. 2, No. 5, 09.1989, p. 315-323.

Research output: Contribution to journalArticle

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AU - Dillon, J. C.

AU - Armstrong, W. F.

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