[Results of local intracoronary fibrinolysis in acute myocardial infarct and the effects of reperfusion on the function of the left ventricle].
Out of 46 patients who had undergone acute coronary angiography in 41 a definitive acute myocardial infarction was present. In 31 complete and in 10 cases subtotal obliterations of the infarct-related coronary artery were found. 14 patients had a one-vessel-disease, 8 a two-vessel-disease, but 19 a three-vessel-disease. In these 41 patients with acute myocardial infarction a subsequent intracoronary fibrinolysis therapy with streptokinase or urokinase immediately followed, which was successful in 33 patients (80.5%). Coronarographically neither a recanalization or a marked improvement of luminal patency of the infarct-related coronary artery could be proved. In 4 patients an additional guidewire thrombus perforation was necessary. The intracoronary fibrinolysis lasted maximally 2 hours (average total dosage 121.000 +/- 45.000 U streptokinase) and was essentially well tolerated. Only 3 patients of the treatment group died. 20 patients underwent a repeated angiography on average 8 1/2 months after fibrinolysis therapy, out of this group in 10 successfully treated patients comparable quantitative angiographic investigations are present. Heart index, stroke volume and systolic ejection fraction improved significantly. The percental size of the non-contracting area of the myocardium decreased statistically significantly. The recanalized coronary arteries were still patent at control.
D002302:Cardiac Output / Q000187:drug effects; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects*; D003331:Coronary Vessels / Q000187:drug effects; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006352:Heart Ventricles / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013300:Streptokinase / Q000627:therapeutic use*; D013318:Stroke Volume / Q000187:drug effects; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator
Ergebnisse der lokalen intrakoronaren Fibrinolyse beim akuten Myokardinfarkt und Auswirkungen der Reperfusion auf die Funktion des linken Ventrikels.