Influence of thrombolytic therapy on early and long term leftventricular systolic function in patients with ST-segment elevation myocardial infarction
DOI:
https://doi.org/10.15218/zjms.2011.0004Keywords:
Left ventricular systolic functionAbstract
Background and objectives: Left ventricular systolic dysfunction complicating acute myocardial infarction are responsible for significant morbidity and mortality. This study to assess the effect of thrombolytic therapy on the left ventricular systolic function during the first week and a year after ST- elevation myocardial infarction.
Methods: In a study of 56 patients with first ST-Segment elevation myocardial infarction (42 men and 14 women; age range, 42-89 years (mean, 61 ± 10), who had been admitted to the Coronary Care Unit at Hawler Teaching Hospital from May 2008 to May 2009. study done to assess the left ventricular systolic function during the first week and first year after ST-elevation myocardial infarction.
Twenty one patients received tissue plasminogen activator (Alteplase) 12 hour after the onset of symptoms labeled as group-I, the remaining patients (35), had no chance to receive thrombolytic therapy labeled as group II.
Results: In group I the mean ejection fraction improved significantly from 51.6±9.4 during the first week to 55.14±11, P=0.034, at first year after acute myocardial infarction, while in group II there was no significant difference of mean ejection fraction during the first week (45.97±12.2) and first year of acute myocardial infarction (46.1±13.2),P=0.5.
Conclusions: Thrombolytic therapy has a beneficial effect on left ventricular systolic function detected by echocardiography at the end of the first year of ST-elevation myocardial infarction
Metrics
References
Volpi A, De Vita C, Ranzosi MG, et al. Determinants of 6-month mortality in survivors of acute myocardial infarction after thrombolysis results of the GISSI-2 database. Circulation 1993;88:416-29.
Multicenter Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983;309:331-6.
Skali H, Zornoff LA, Pfeffer MA Arnold MO,Lamas GA,et al ,prognostic use of Echocardiography 1 year after a myocardial infarction,American Heart Journal, 2005;150(4):743-749.
Contor W.J et al. Criteria for the diagnosis of ST-elevation myocardial infarction.NEJM: 2009:360,2795-18
Antman EM. ST-elevation myocardial infarction:Management.In Braunwald s Heart Disease.Edited by: Braunwald E,Bonow RO,Libby P,Zipes DP 8th Edition. Saunders Elsevier, 2008,PP1167-1226
Anamia G,Sauval p, Lablnche JM, et al: Impact of prehospital thrombolysis on 1- month outcome after ST-elevation myocardial infarction: Data from the nationwide French USIC 2000 survy.Abstract 2703.Vienna,European Society of Cardiology,2003.
Bloomfield P, Bradbury A, Grubb NR. Obesity, presenting problems of altered energy balane, Enviromental and nutritional factors in disease. In Davidson's Principles and Practice of Medicine. Edited by Bloomfield P, Bradbury A, Grubb N.20th Edition, London, Churchill livingstone,2006,pp111-112.
Ramdas G, Pai and Pravin M.Shah, Assessment of left ventricular function . in Imaging in Cardiovascular Disease, Edited by Gerald M. pohost,Robert A.O,Daniel S, Berman,Pravin m,Lippincott Williams & Wilkins. 2000, pp23-41.
Gibbons RJ, Balady GJ, Bricker JT, et al ACC/AHA. guide line up date fore exercise testing. Summery article. A report of the ACC/AHA task force or practice guidelines (Committee to up date). (2002).
.Schiller N, Shah PM,Crawford M. Recommendation for quantitation of the left ventricle by two-dimensional echocardiography.J Am Soc Echocardiography 1989;2:358-68.
Schoming A, Ndrepepa G, Mehilli j, et al: Therapy–dependent influence of time to treatment interval on myocardial salvage in patients with acute myocardial infarction treated with coronary artery stenting or thrombolysis,Circulation 108:1084,2003
Bolli R. Myocardial 'stunning' in man. Circulation. Dec 1992; 86(6):1671-91.
Pfeffer MA, Pfeffer JM, Fisbein MC,et al. Myocardial infarct size and ventricular function in rats. Circ Res. 1979; 44: 503-512.
Solomon SD, Glynn RJ, Greaves S, et al. Recovery of ventricular function after myocardial infarction in the reperfusion era: the healing and early afterload reducing therapy study. Ann Intern Med. 2001; 134: 451-458
Lee H, Eisenberg MJ, Schiller NB, Serial assessment of left ventricular function after myocardial infarction. Am Heart J. 1995;130: 999-1002.
Verani MS, Tortoledo FE, Batty JW, et al. Effect of coronary artery recanalization on right ventricular function in patients with acute myocardial infarction. J Am Coll Cardiol. 1985; 5: 1029-1035.
Pfeffer MA, Braunwald E. Ventricular remodeling after myocardial infarction.Circulation 1990; 81: 1161-1172
Bolognese L, Carrabba N, Parodi G, Santoro GM, Buonamici P, Cerisano G, Antoniucci D. Impact of microvascular dysfunction on left ventricular remodeling and long-term clinical outcome after primary coronary angioplasty for acute myocardial infarction. Circulation 2004; 109: 1121-1126
Hayat SA, Senior R. Myocardial contrast echocardiography in ST elevation myocardial infarction: ready for prime time? Eur Heart J 2008; 29: 299-314.
Sheiban I,Fragasso G,Lu C,Tonni S,Trevi GP, and Chierchia SL,Influence of treatment delay on long-term left ventricular function in patients with acute myocardial infarction successfully treated with primary angioplasty;American Heart Journal 2001;141(4)
Klein MD,Herman MV,Gorlin R.A hemodynamic study of left ventricular aneurysm,Circulation 1967;35:614-30
Pfeffer MA : Left ventricular remodeling after acute myocardial infarction. Ann Rev Med.1995 46:455.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2011 Mohammed Hassan Alwan, Abdulkareem A. AL-Othman (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
