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

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

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Abstract

Although global and regional left ventricular (LV) function has been demonstrated to improve after reperfusion in acute myocardial infarction (AMI), the timing of these changes has not been well established. In this study, serial 2-dimensional echocardiography was used to assess regional LV function in 23 patients with AMI in whom reperfusion was accomplished by thrombolysis alone, by coronary angioplasty alone or by both interventions within 6 hours after onset of chest pain. Echocardiograms were performed before or within 6 hours after reperfusion (n = 23) and at 1 (n = 19), 3 (n = 21) and 7 (n = 20) days after reperfusion. Wall motion index and percentage of normally functioning muscle were calculated using a 16-segment scoring system analyzed in blinded fashion without knowledge of patient identity, therapy or time of study. The mean wall motion index improved from 1.78 ± 0.48 to 1.56 ± 0.38 at 1 day (n = 19, p < 0.01), and to 1.48 ± 0.37 at 3-7 days (p < 0.01), with no significant difference between 3 days (1.49 ± 0.39) and 7 days (1.42 ± 0.30). There was a corresponding improvement in the percentage of normally functioning muscle, from 53 ± 24% at 6 hours to 62 ± 20% at 1 day (p < 0.05) and to 67 ± 18% at 3-7 days (p < 0.01), again with no significant difference between 3 days (67 ± 21) and 7 days (70 ± 20). The data indicate that in many patients with AMI and successful reperfusion there was a rapid improvement in LV wall motion abnormalities, often within 24 hours. In most patients maximal improvement was seen within 3 days.

Original languageEnglish
Pages (from-to)641-646
Number of pages6
JournalThe American Journal of Cardiology
Volume63
Issue number11
DOIs
StatePublished - Mar 15 1989

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Left Ventricular Function
Reperfusion
Echocardiography
Myocardial Infarction
Muscles
Time and Motion Studies
Chest Pain
Angioplasty
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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; Davis, Cris; Dillon, James C.; Armstrong, William F.; Fineberg, Naomi; Ryan, Thomas; Feigenbaum, Harvey.

In: The American Journal of Cardiology, Vol. 63, No. 11, 15.03.1989, p. 641-646.

Research output: Contribution to journalArticle

Bourdillon, Patrick D V ; Broderick, Thomas M. ; Williams, Eric ; Davis, Cris ; Dillon, James C. ; Armstrong, William F. ; Fineberg, Naomi ; Ryan, Thomas ; Feigenbaum, Harvey. / Early recovery of regional left ventricular function after reperfusion in acute myocardial infarction assessed by serial two-dimensional echocardiography. In: The American Journal of Cardiology. 1989 ; Vol. 63, No. 11. pp. 641-646.
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abstract = "Although global and regional left ventricular (LV) function has been demonstrated to improve after reperfusion in acute myocardial infarction (AMI), the timing of these changes has not been well established. In this study, serial 2-dimensional echocardiography was used to assess regional LV function in 23 patients with AMI in whom reperfusion was accomplished by thrombolysis alone, by coronary angioplasty alone or by both interventions within 6 hours after onset of chest pain. Echocardiograms were performed before or within 6 hours after reperfusion (n = 23) and at 1 (n = 19), 3 (n = 21) and 7 (n = 20) days after reperfusion. Wall motion index and percentage of normally functioning muscle were calculated using a 16-segment scoring system analyzed in blinded fashion without knowledge of patient identity, therapy or time of study. The mean wall motion index improved from 1.78 ± 0.48 to 1.56 ± 0.38 at 1 day (n = 19, p < 0.01), and to 1.48 ± 0.37 at 3-7 days (p < 0.01), with no significant difference between 3 days (1.49 ± 0.39) and 7 days (1.42 ± 0.30). There was a corresponding improvement in the percentage of normally functioning muscle, from 53 ± 24{\%} at 6 hours to 62 ± 20{\%} at 1 day (p < 0.05) and to 67 ± 18{\%} at 3-7 days (p < 0.01), again with no significant difference between 3 days (67 ± 21) and 7 days (70 ± 20). The data indicate that in many patients with AMI and successful reperfusion there was a rapid improvement in LV wall motion abnormalities, often within 24 hours. In most patients maximal improvement was seen within 3 days.",
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N2 - Although global and regional left ventricular (LV) function has been demonstrated to improve after reperfusion in acute myocardial infarction (AMI), the timing of these changes has not been well established. In this study, serial 2-dimensional echocardiography was used to assess regional LV function in 23 patients with AMI in whom reperfusion was accomplished by thrombolysis alone, by coronary angioplasty alone or by both interventions within 6 hours after onset of chest pain. Echocardiograms were performed before or within 6 hours after reperfusion (n = 23) and at 1 (n = 19), 3 (n = 21) and 7 (n = 20) days after reperfusion. Wall motion index and percentage of normally functioning muscle were calculated using a 16-segment scoring system analyzed in blinded fashion without knowledge of patient identity, therapy or time of study. The mean wall motion index improved from 1.78 ± 0.48 to 1.56 ± 0.38 at 1 day (n = 19, p < 0.01), and to 1.48 ± 0.37 at 3-7 days (p < 0.01), with no significant difference between 3 days (1.49 ± 0.39) and 7 days (1.42 ± 0.30). There was a corresponding improvement in the percentage of normally functioning muscle, from 53 ± 24% at 6 hours to 62 ± 20% at 1 day (p < 0.05) and to 67 ± 18% at 3-7 days (p < 0.01), again with no significant difference between 3 days (67 ± 21) and 7 days (70 ± 20). The data indicate that in many patients with AMI and successful reperfusion there was a rapid improvement in LV wall motion abnormalities, often within 24 hours. In most patients maximal improvement was seen within 3 days.

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