title: Effect on global and regional left ventricular functions by percutaneous transluminal coronary angioplasty in the chronic stage after myocardial infarction.
abstract: Data are reported on 145 consecutive patients with prior myocardial infarction who had successful percutaneous transluminal coronary angioplasty (PTCA) of the infarct-related artery (5 +/- 6 months after infarction), and left ventricular (LV) angiograms before PTCA and during follow-up (7 +/- 4 months). There was a significant long-term improvement in LV function, ejection fraction increased from 60 +/- 13% to 64 +/- 13% (p less than 0.001), and regional wall motion abnormalities decreased by 40%. Multivariate discriminant analysis identified reduced LV function and a high degree of stenosis before PTCA as predictors for improvement in LV function (ejection fraction less than 60%: ejection fraction from 48 +/- 9% to 57 +/- 14%, p less than 0.001; and stenosis greater than or equal to 90%: ejection fraction from 59 +/- 15% to 66 +/- 14%, p = 0.003). Restenosis greater than or equal to 90% in patients with initial stenosis less than 90% decreased ejection fraction from 59 +/- 16% to 51 +/- 14% (p less than 0.05). Other factors tested (treatment of infarction by thrombolysis, time between infarction and PTCA, and severity of angina pectoris) had no effect on long-term changes in LV function. It is concluded that successful elective PTCA of a high-grade stenosis in an infarct-related artery may improve LV ejection fraction and regional wall motion abnormalities, especially in patients with impaired LV function.
authors.affiliation: Department of Cardiology, Klinikum Steglitz, Free University of Berlin, Federal Republic of Germany.
authors.forename: T
authors.initials: T
authors.lastname: Linderer
authors.forename: B
authors.initials: B
authors.lastname: Guhl
authors.forename: C
authors.initials: C
authors.lastname: Spielberg
authors.forename: W
authors.initials: W
authors.lastname: Wunderlich
authors.forename: L
authors.initials: L
authors.lastname: Schnitzer
authors.forename: R
authors.initials: R
authors.lastname: Schröder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy*; D012008:Recurrence; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000502:physiology*