title: Increasingly well-preserved left ventricular function in hospital survivors with acute myocardial infarction: effect of early and complete reperfusion strategy on left ventricular remodeling.
abstract: BACKGROUND
  Progress in reperfusion therapy for acute myocardial infarction (AMI) has greatly reduced acute phase mortality, but few data exist regarding the time trends in left ventricular (LV) remodeling in hospital survivors of AMI.
  
  
  RESULTS
  The study enrolled 813 patients with AMI who had received reperfusion therapy and survived to hospital discharge. The patients were divided into chronological groups: first treatment received between 1989 and 1992, n=196; 1993 and 1995, n=193; 1996 and 1998, n=211; and 1999 and 2002, n=213. A comparison was made of LV ejection fraction (LVEF) and LV end-diastolic volume index (LVEDVI) at 6 months after symptom onset. Along with the temporal improvements reperfusion therapy, LVEF and LVEDVI improved over time (55+/-14, 58+/-13, 59+/-13, 61+/-13%, p<0.001; 98+/-30, 94+/-27, 90+/-31, 76+/-27 ml/m2, p<0.0001). Multiregression analysis revealed that shortening of the door-to-Thrombolysis In Myocardial Infarction (TIMI)-3 time (time interval from arrival at the emergency room until patients achieved TIMI-3 flow) and achieving substantial TIMI-3 flow were independent predictors for LV remodeling.
  
  
  CONCLUSIONS
  Although this was a retrospective analysis, the results demonstrated that the change in reperfusion therapy aiming at complete reperfusion at an earlier stage after AMI onset has contributed to improving post-MI remodeling.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. tanishigem@yahoo.co.jp
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Tani
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.forename: Ikuyoshi
authors.initials: I
authors.lastname: Watanabe
authors.forename: Kimio
authors.initials: K
authors.lastname: Kikushima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Takeo
authors.initials: T
authors.lastname: Anazawa
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawamata
authors.forename: Eizo
authors.initials: E
authors.lastname: Tachibana
authors.forename: Michiaki
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Takamichi
authors.initials: T
authors.lastname: Kumabe
authors.forename: Katsuo
authors.initials: K
authors.lastname: Kanmatsuse
authors.forename: Toshio
authors.initials: T
authors.lastname: Kushiro
mesh_terms: D000208:Acute Disease; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D013927:Thrombosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*