[Delayed angioplasty of residual coronary stenosis after thrombolysis of myocardial infarction: prognostic factors of left ventricular function].
The aim of this study was to analyse the prognostic factors of long term left ventricular function after successful delayed angioplasty of residual coronary stenosis after thrombolysis for myocardial infarction. The left ventricular function of fifty patients, aged 54 +/- 10 years, who underwent intravenous thrombolysis 2.9 +/- 1.3 hours after the onset of myocardial infarction (28 anterior, 22 inferior wall) was assessed by angiography at the 6.1 +/- 1.7th day and 6.1 +/- 2.5 months after successful angioplasty undertaken on the 8.3 +/- 5.2nd day. In cases without reocclusion (n = 44), the ejection fraction and the wall motion of the infarcted region improved significantly from 56.8 +/- 12.2% to 59.5 +/- 15.4% (p < 0.002) and from 8.4 +/- 14.8% to 18.3 +/- 24.3% (p = 0.0001), respectively. These parameters did not change in cases with reocclusion (n = 6). When the dilated artery remained patent, an improvement in motion of the infarcted region was observed in 69.5% of hypokinesis (n = 23), 50% of akinesis (n = 10) and 9.1% of dyskinesis (n = 11) (p < 0.005). The improvement in motion of the infarcted zone was negatively correlated with the delay of thrombolysis (r = 0.36; p < 0.02) and peak CPK levels (r = 0.31; p < 0.04). Over 60% restenosis on digitalised densitometry (n = 11) did not compromise the possibilities of improvement, the evolution of wall motion of the infarcted zone and volumes with respect to cases without restenosis (n = 33).(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy*; D015425:Myocardial Reperfusion; D011379:Prognosis; D012008:Recurrence; D013318:Stroke Volume; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
Angioplastie différée de la sténose résiduelle après thrombolyse de l'infarctus du myocarde: facteurs déterminant l'évolution de la fonction ventriculaire gauche.