Comparison of time of reperfusion during anterior wall acute myocardial infarction to left ventricular volume one month and 20 months later.
We studied 95 patients with a first anterior wall acute myocardial infarction who received successful reperfusion within 72 hours after the onset. The patients were divided into 4 groups based on the time required to achieve reperfusion; <3 hours (n = 23), 3 to 6 hours (n = 42), 6 to 24 hours (n = 17), and >24 to 72 hours (n = 13). The infarct size, as evaluated by thallium-201 single-photon emission computed tomography, at 1 month after the infarct was significantly larger (p <0.05) in >24 to 72 hours (1,593 +/- 652 U) than that in <3 hours (749 +/- 650 U), but was not significantly different from that at 3 to 6 hours (1,353 +/- 770 U) or 6 to 24 hours (1,371 +/- 561 U). The end-diastolic volume index at 1 month did not differ among the 4 groups. However, the end-diastolic volume index during the follow-up period (20 +/- 8 months) in >24 to 72 hours (93 +/- 23 ml/m(2)) was significantly larger than that in the other 3 groups (<3 hours [65 +/- 21 ml/m(2)], 3 to 6 hours [65 +/- 22 ml/m(2)], and 6 to 24 hours [70 +/- 25 ml/m(2)]). Similar findings were observed in end-systolic volume index. In conclusion, although infarct size reduction was not observed by late reperfusion, left ventricular volumes at 1 month were comparable among patients with successful reperfusion within 3 and up to >24 hours. Left ventricular volumes 2 years after acute myocardial infarction were significantly larger in patients who did not under reperfusion for >24 hours.
Hirayama
Atsushi
A
Cardiovascular Division, Osaka Police Hospital, Osaka, Japan. ahirayama@oph.gr.jp
Kusuoka
Hideo
H
Adachi
Takayoshi
T
Sakai
Akihiko
A
Ueda
Yasunori
Y
Okuyama
Yuji
Y
Fuji
Hisakazu
H
Sakata
Yasuhiko
Y
Sakata
Yasushi
Y
Asakura
Masanori
M
Yamamoto
Hiroyoshi
H
Higuchi
Yasuharu
Y
Hori
Masatusugu
M
Kodama
Kazuhisa
K
D000368:Aged; D000704:Analysis of Variance; D017130:Angioplasty; D006328:Cardiac Catheterization; D016009:Chi-Square Distribution; D004108:Dilatation, Pathologic / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D012008:Recurrence; D015912:Thrombolytic Therapy; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D016277:Ventricular Function, Left