A revascularizaçäo precoce das artérias näo relacionadas ao infarto melhora a funçäo regional e global do ventrículo esquerdo após o infarto agudo do miocárdio / Early Noninfarct Related Arteries Revascularization Improves Regional Wall Motion Post Myocardial Infarction
Arq. bras. cardiol
; 61(6): 337-343, dez. 1993. tab
Artigo
em Português
| LILACS
| ID: lil-148883
Biblioteca responsável:
BR1.1
ABSTRACT
PURPOSE--To evaluate if early interventions which increase flow in the non-infarct related arteries (NRA) could improve long-term ventricular function in the non-infarct (NI) area after an acute myocardial infarction (MI). METHODS--We studied regional wall motion analyzed by the center-line method in two groups of patients with significant stenoses (> or = 70 per cent ) in the NRA after successful coronary reperfusion (chemical or mechanical thrombolysis). Group I (GI) consisted of 21 patients that were submitted to early (mean 14 days) complete surgical revascularization of both NRA and infarct related artery (IRA); the 12 group II (GII) patients underwent successful revascularization of the IRA only, with percutaneous transluminal coronary angioplasty (mean 6 days). Paired ventriculograms were obtained within 48 hours of the infarction and a mean of 17 months later. RESULTS--NI area contractility in GI patients improved from -0.35 +/- 2.16 to +0.62 +/- 1.6sd/chord (p < 0.05), whereas in GII decreased from +0.54 +/- 1.78 to -0.66 +/- 1.72 sd/chord (p < 0.05), p < 0.05 between the groups at follow-up. Mean infarct area wall motion did not differ between the two groups from -3.04 +/- 2.43 to 2.61 +/- 2.49 sd/chord in GI (p = NS), and from -2.68 +/- 2.54 to -2.93 +/- 2.35 sd/chord in GII (p = NS). Mean global left ventricular (LV) ejection fraction did not change in GII patients (0.72 +/- 0.09 and 0.67 +/- 0.12, p = NS), but significantly increased from 0.63 +/- 0.12 to 0.72 +/- 0.11 in GI patients (p < 0.01). CONCLUSION--These data suggest that early revascularization of NRA with significant stenoses can improve not only the NI area regional contractility, but also the global LV function in the long-term follow-up of post MI patients treated with thrombolytic therapy
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Função Ventricular Esquerda
/
Infarto do Miocárdio
/
Revascularização Miocárdica
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Português
Revista:
Arq. bras. cardiol
Assunto da revista:
Cardiologia
Ano de publicação:
1993
Tipo de documento:
Artigo