[Evolution of systolic function and myocardial perfusion, evaluated by gated-SPECT, in the first year after acute myocardial infarction].
OBJECTIVE
Systolic function and myocardial perfusion are evaluated before hospital discharge and can change during follow-up. The purpose of this study was to evaluate these parameters by gated-SPECT in the first year after acute myocardial infarction.


METHODS
We studied 74 consecutive patients with a first uncomplicated acute myocardial infarction (49 infero-lateral and 25 anterior) by stress-rest 99mTc-tetrofosmin and rest-gated-SPECT before hospital discharge (6-8 days after admission) and one year after myocardial infarction.


RESULTS
The ejection fraction (EF) increased > 5% in 51% of infero-lateral infarcts and 28% of non-revascularized anterior infarcts. EF increased significantly (48.4 8% to 54.6 8.7%; p < 0.0001, mean difference: 6.2; 95% IC, 2.8-9.5) and systolic volume decreased (51.3 19.2 ml to 44.3 19.4 ml; p = 0.001; mean diff.: 7.67; 95% IC, 1.5-13.8) in infero-lateral infarctions. The rest perfusion index in the necrotic region improved (2.3 0.57 to 2.17 0.58; p = 0.004; mean diff.: 0.18; 95% IC, 0.003-0.36) in infero-lateral infarcts and the ischemia index remained unchanged between the first and second studies.


CONCLUSIONS
Left ventricular systolic function can change during the first year of evolution, a significant improvement being seen in infero-lateral infarctions. The ejection fraction increased > 5% in half of these patients, as opposed to only a quarter of anterior infarctions. This improvement was associated to increased myocardial perfusion at rest.
Servicios de Cardiología y de Medicina Nuclear. Hospital Universitari Vall d'Hebron. Barcelona. España. jcandell@hg.vhebron.es
Jaume
J
Candell-Riera
Osvaldo
O
Pereztol-Valdés
Guillermo
G
Oller-Martínez
Joan
J
Llevadot
Santiago
S
Aguadé-Bruix
Joan
J
Castell-Conesa
Marina
M
Soler-Peter
Marc
M
Simó
Jordi
J
Soler-Soler
D000368:Aged; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D013318:Stroke Volume / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left / Q000502:physiology