Myocardial viability: impact on left ventricular dilatation after acute myocardial infarction.

نویسندگان

  • F Nijland
  • O Kamp
  • P M J Verhorst
  • W G de Voogt
  • H G Bosch
  • C A Visser
چکیده

OBJECTIVE To evaluate whether the presence of viable myocardium, detected by low dose dobutamine echocardiography, limits the likelihood of left ventricular dilatation in patients with acute myocardial infarction. PATIENTS 107 patients were studied by low dose dobutamine echocardiography at (mean (SD)) 3 (1) days after acute myocardial infarction. Cross sectional echocardiography was repeated three months later. Patients were divided in two groups based on the presence (n = 47) or absence (n = 60) of myocardial viability. RESULTS Baseline characteristics were comparable between the two groups, except for infarct location. Left ventricular end diastolic volume index (EDVI) was stable in patients with viability, but end systolic volume index (ESVI) decreased significantly (p = 0.006). Patients without viability had a significant increase in both EDVI (p < 0.0001) and ESVI (p = 0.0007). Subgroup analysis in patients with small and large infarcts (peak creatine kinase < or = 1000 v > 1000 IU/l) showed that ventricular dilatation occurred only in patients with large infarcts without viability. This resulted in larger ESVI values at three months in that group compared with patients with large infarcts plus viability (p < 0.05). Multivariate regression analysis identified myocardial viability as an independent predictor of left ventricular dilatation, along with wall motion score index on low dose dobutamine echocardiography and the number of pathological Q waves. CONCLUSIONS The presence of viability early after acute myocardial infarction is associated with preservation of left ventricular size, whereas the absence of viability results in ventricular dilatation, particularly in large infarcts.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

CARDIOVASCULAR MEDICINE Myocardial viability: impact on left ventricular dilatation after acute myocardial infarction

Objective: To evaluate whether the presence of viable myocardium, detected by low dose dobutamine echocardiography, limits the likelihood of left ventricular dilatation in patients with acute myocardial infarction. Patients: 107 patients were studied by low dose dobutamine echocardiography at (mean (SD)) 3 (1) days after acute myocardial infarction. Cross sectional echocardiography was repeated...

متن کامل

Myocardial damage of the entire ventricular region in a patient with acute myocardial infarction

Technetium-99m-pyrophosphate (99mTc-PYP) has been used, in combination with thallium-201, to estimate the site and extent of myocardial infarcts. We report a case of acute myocardial infarction with severe coronary disease in which the distribution of 99mTc-PYP was extensive. A 78-year-old man presented with dyspnea, and a diagnosis of non-ST-segment elevation acute myocar...

متن کامل

CARDIOVASCULAR MEDICINE Impact of microvascular integrity and local viability on left ventricular remodelling after reperfused acute myocardial infarction

Objective: To assess left ventricular remodelling in patients with reperfused acute myocardial infarction and to study its relation to microvascular damage. Patients: 25 patients successfully treated by primary percutaneous coronary angioplasty for acute myocardial infarction. Setting: University hospital Methods: Indexed end diastolic (EDVi) and end systolic (ESVi) volumes were assessed on adm...

متن کامل

Impact of microvascular integrity and local viability on left ventricular remodelling after reperfused acute myocardial infarction.

OBJECTIVE To assess left ventricular remodelling in patients with reperfused acute myocardial infarction and to study its relation to microvascular damage. PATIENTS 25 patients successfully treated by primary percutaneous coronary angioplasty for acute myocardial infarction. SETTING University hospital METHODS Indexed end diastolic (EDVi) and end systolic (ESVi) volumes were assessed on a...

متن کامل

The effect of eight weeks of moderate-intensity endurance training on myocardial capillary density, ejection fraction and left ventricular shortening fraction in male rats with myocardial infarction

Background and objective: Vascular obstruction and impaired blood flow and oxygen delivery cause a myocardial infarction and limit a personchr('39')s function. Therefore, finding a way to create new arteries and replace blocked arteries has always been of interest to researchers, including exercise physiologists. Therefore, this study was conducted to evaluate the effect of eight weeks of moder...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Heart

دوره 87 1  شماره 

صفحات  -

تاریخ انتشار 2002