Long-term stepwise sustained improvement in left ventricular ejection fraction after myocardial infarction.
Radionuclide left ventricular ejection fraction, end-diastolic volume, and exercise capacity were determined in 34 selected patients who survived a first Q wave anterior infarction. Patients were included in the study if they had no subsequent cardiac events (unstable angina or myocardial infarction) during the average follow-up period of 47 months (range = 36 to 70 months); none was treated with thrombolysis, coronary angioplasty, or bypass grafting. Overall, mean left ventricular ejection fraction increased from 28 +/- 10% 1 month after infarction to 33 +/- 10% at 3 years (p less than 0.01); mean end-diastolic volume decreased from 217 +/- 99 ml to 171 +/- 80 ml (p less than 0.002). Stepwise improvement in left ventricular ejection fraction occurred in 15 of these patients (group B) and was associated with a significant increase in exercise capacity. Mean ejection fraction in group B was 26 +/- 7% at 1 month and 41 +/- 10% at 3 years (p less than 0.001). In all of these patients there was improved regional wall motion in the noninfarct zone, whereas five patients also showed improvement in the infarct zone. The results indicate a progressive improvement in left ventricular function that occurs over time in some patients after first Q wave anterior infarction, independent of intervention.
Silberberg
J
J
Division of Cardiology, Royal Victoria Hospital, Montreal, Quebec, Canada.
Haichin
R
R
Stewart
S
S
Lisbona
R
R
Sniderman
A
A
D000328:Adult; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D013318:Stroke Volume