TY - JOUR
T1 - Effects of successful intravenous reperfusion therapy on regional myocardial function and geometry in humans
T2 - a tomographic assessment using two-dimensional echocardiography
AU - Touchstone, Dale A.
AU - Beller, George A.
AU - Nygaard, Thomas W.
AU - Tedesco, Christine
AU - Kaul, Sanjiv
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1989/6
Y1 - 1989/6
N2 - This study tested the hypothesis that reperfusion therapy might provide benefit at two levels: 1) by arresting infarct migration at the endocardial level, such that partial or complete recovery of regional function occurs; and 2) if the former is not achieved, by preventing complete or near complete transmural migration and subsequent infarct expansion. To test this hypothesis, 24 patients who received intravenous streptokinase therapy within 4 h of chest pain were studied prospectively. All patients underwent two-dimensional echocardiography at the time of admission and 1, 2, 3 and 10 days later. The patients also underwent coronary angiography 2 h after completion of streptokinase therapy. Although 18 (75%) of the 24 patients had a patent infarct-related artery, only 8 (45%) of the 18 patients with this finding showed improvement in regional function. Improvement was not evident until 3 to 10 days after streptokinase therapy. In addition to the presence of an open infarct-related artery, the interval between chest pain and onset of streptokinase therapy (2.5 ± 0.5 versus 3.2 ± 0.7 h, p = 0.02) differed significantly between patients who did or did not show improved regional function. Of the 15 of 16 patients with no improvement in regional function, 4 showed infarct expansion, and all had a closed infarct-related artery compared with only 2 of the 11 not showing expansion (p = 0.01). In conclusion, intravenous streptokinase given within 4 h of chest pain results in improvement in regional function in about 33% of the patients, presumably by arresting the infarction within the endocardium. In another 50%, although streptokinase does not cause recovery in regional function, it preserves local geometry by preventing complete or near complete transmural infarction.
AB - This study tested the hypothesis that reperfusion therapy might provide benefit at two levels: 1) by arresting infarct migration at the endocardial level, such that partial or complete recovery of regional function occurs; and 2) if the former is not achieved, by preventing complete or near complete transmural migration and subsequent infarct expansion. To test this hypothesis, 24 patients who received intravenous streptokinase therapy within 4 h of chest pain were studied prospectively. All patients underwent two-dimensional echocardiography at the time of admission and 1, 2, 3 and 10 days later. The patients also underwent coronary angiography 2 h after completion of streptokinase therapy. Although 18 (75%) of the 24 patients had a patent infarct-related artery, only 8 (45%) of the 18 patients with this finding showed improvement in regional function. Improvement was not evident until 3 to 10 days after streptokinase therapy. In addition to the presence of an open infarct-related artery, the interval between chest pain and onset of streptokinase therapy (2.5 ± 0.5 versus 3.2 ± 0.7 h, p = 0.02) differed significantly between patients who did or did not show improved regional function. Of the 15 of 16 patients with no improvement in regional function, 4 showed infarct expansion, and all had a closed infarct-related artery compared with only 2 of the 11 not showing expansion (p = 0.01). In conclusion, intravenous streptokinase given within 4 h of chest pain results in improvement in regional function in about 33% of the patients, presumably by arresting the infarction within the endocardium. In another 50%, although streptokinase does not cause recovery in regional function, it preserves local geometry by preventing complete or near complete transmural infarction.
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U2 - 10.1016/0735-1097(89)90340-9
DO - 10.1016/0735-1097(89)90340-9
M3 - Article
C2 - 2723266
AN - SCOPUS:0024401894
SN - 0735-1097
VL - 13
SP - 1506
EP - 1513
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 7
ER -