PMID- 1572028
OWN - NLM
STAT- MEDLINE
DCOM- 19920601
LR  - 20190623
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 85
IP  - 5
DP  - 1992 May
TI  - Lack of myocardial perfusion immediately after successful thrombolysis. A 
      predictor of poor recovery of left ventricular function in anterior myocardial 
      infarction.
PG  - 1699-705
AB  - BACKGROUND: We investigated myocardial perfusion dynamics after thrombolysis and 
      its clinical implications. METHODS AND RESULTS: We studied 39 patients with acute 
      anterior myocardial infarction (AMI). Myocardial contrast echocardiography (MCE) 
      was performed before and immediately after successful reflow with intracoronary 
      injection of sonicated Ioxaglate. The average segmental score by two-dimensional 
      echocardiography (graded 0, normal, to 3, akinetic/dyskinetic) and global 
      ejection fraction (left ventricular ejection fraction, LVEF%) by left 
      ventriculography were measured at 1 day and at 4 weeks after reflow. Hypokinesis 
      in the infarct region was assessed by the centerline method and expressed in 
      terms of standard deviations (regional wall motion [RWM]: SD/chord) of normal. 
      Immediately after reflow, 30 of 39 patients (group A) showed significant contrast 
      enhancement within the risk area. The other nine patients (23%, group B), 
      however, showed the residual contrast defect in the risk area (myocardial no 
      reflow). There were no significant differences in the elapsed time, angiographic 
      collateral grade, and degree of residual stenosis between group A and group B. 
      Before reflow, both groups exhibited similar levels of global and regional left 
      ventricular function. Improvement in global (LVEF, average segmental score) and 
      regional left ventricular function was greater in group A than in group B 
      (average segmental score, 0.44 +/- 0.41 versus 0.97 +/- 0.36, p less than 0.01; 
      LVEF, 56.4 +/- 13.4 versus 42.7 +/- 8.9, p less than 0.05; RWM, -1.87 +/- 0.85 
      versus -3.18 +/- 0.52, p less than 0.005). CONCLUSIONS: MCE demonstrates that 
      angiographically successful reflow cannot be used as an indicator of successful 
      myocardial reperfusion in AMI patients. The residual contrast defect in the risk 
      area demonstrated immediately after reflow is a predictor of poor functional 
      recovery of the postischemic myocardium.
FAU - Ito, H
AU  - Ito H
AD  - Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
FAU - Tomooka, T
AU  - Tomooka T
FAU - Sakai, N
AU  - Sakai N
FAU - Yu, H
AU  - Yu H
FAU - Higashino, Y
AU  - Higashino Y
FAU - Fujii, K
AU  - Fujii K
FAU - Masuyama, T
AU  - Masuyama T
FAU - Kitabatake, A
AU  - Kitabatake A
FAU - Minamino, T
AU  - Minamino T
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Fibrinolytic Agents)
RN  - Z40X7EI2AF (Ioxaglic Acid)
SB  - IM
CIN - Circulation. 1992 May;85(5):1942-4. PMID: 1572050
MH  - Coronary Circulation/*drug effects
MH  - Echocardiography
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Forecasting
MH  - Humans
MH  - Ioxaglic Acid/adverse effects/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnostic imaging/*drug therapy/physiopathology
MH  - *Myocardial Reperfusion
MH  - Reproducibility of Results
MH  - *Ventricular Function, Left
EDAT- 1992/05/01 00:00
MHDA- 1992/05/01 00:01
CRDT- 1992/05/01 00:00
PHST- 1992/05/01 00:00 [pubmed]
PHST- 1992/05/01 00:01 [medline]
PHST- 1992/05/01 00:00 [entrez]
AID - 10.1161/01.cir.85.5.1699 [doi]
PST - ppublish
SO  - Circulation. 1992 May;85(5):1699-705. doi: 10.1161/01.cir.85.5.1699.