OBJECTIVES: We sought to evaluate the importance of time in relation to treatment, time course and determinants of recovery of left ventricular (LV) function in patients with acute myocardial infarction (AMI) undergoing primary percutaneous transluminal coronary angioplasty (PTCA). BACKGROUND: Myocardial salvage has been shown to be dependent on the time elapsed from the onset of AMI to reperfusion. METHODS: Left ventricular function was evaluated at hospital admission, after angioplasty, at 24 h and 6 months by both echocardiography and angiography and at 1, 7, 30, 90 and 180 days by echocardiography in 101 consecutive patients. RESULTS: Patients were allocated to three groups according to interval between symptom onset and angioplasty: <2 h (group A), 2 to 4 h (group B) and >4 h (group C). Patients in groups A and B showed a progressive improvement of LV function between day 7 and day 90, which became statistically significant at day 30 (p < 0.01). No LV function changes were noted in group C patients. Thrombolysis In Myocardial Infarction (TIMI) flow grade <3 at 24 h was not associated with any significant change in LV volume and function during the six-month follow-up period. Restenosis, when associated with TIMI flow grade 3 in the infarct-related vessel, did not influence LV function. Flow grade <3 of the infarct-related artery was not associated with any improvement of cardiac events independently from the time to treatment at the initial procedure. CONCLUSIONS: Patients undergoing primary PTCA for AMI have a good recovery of LV function if TIMI flow grade 3 is restored within 4 h. Coronary angioplasty limits further remodeling of the LV in patients treated after 4 h.
OBJECTIVES: We sought to evaluate the importance of time in relation to treatment, time course and determinants of recovery of left ventricular (LV) function in patients with acute myocardial infarction (AMI) undergoing primary percutaneous transluminal coronary angioplasty (PTCA). BACKGROUND: Myocardial salvage has been shown to be dependent on the time elapsed from the onset of AMI to reperfusion. METHODS: Left ventricular function was evaluated at hospital admission, after angioplasty, at 24 h and 6 months by both echocardiography and angiography and at 1, 7, 30, 90 and 180 days by echocardiography in 101 consecutive patients. RESULTS:Patients were allocated to three groups according to interval between symptom onset and angioplasty: <2 h (group A), 2 to 4 h (group B) and >4 h (group C). Patients in groups A and B showed a progressive improvement of LV function between day 7 and day 90, which became statistically significant at day 30 (p < 0.01). No LV function changes were noted in group C patients. Thrombolysis In Myocardial Infarction (TIMI) flow grade <3 at 24 h was not associated with any significant change in LV volume and function during the six-month follow-up period. Restenosis, when associated with TIMI flow grade 3 in the infarct-related vessel, did not influence LV function. Flow grade <3 of the infarct-related artery was not associated with any improvement of cardiac events independently from the time to treatment at the initial procedure. CONCLUSIONS:Patients undergoing primary PTCA for AMI have a good recovery of LV function if TIMI flow grade 3 is restored within 4 h. Coronary angioplasty limits further remodeling of the LV in patients treated after 4 h.
Authors: Arshed A Quyyumi; Alejandro Vasquez; Dean J Kereiakes; Marc Klapholz; Gary L Schaer; Ahmed Abdel-Latif; Stephen Frohwein; Timothy D Henry; Richard A Schatz; Nabil Dib; Catalin Toma; Charles J Davidson; Gregory W Barsness; David M Shavelle; Martin Cohen; Joseph Poole; Thomas Moss; Pamela Hyde; Anna Maria Kanakaraj; Vitaly Druker; Amy Chung; Candice Junge; Robert A Preti; Robin L Smith; David J Mazzo; Andrew Pecora; Douglas W Losordo Journal: Circ Res Date: 2016-11-07 Impact factor: 17.367
Authors: LeRoy Elazar Rabbani; Carol Waksmonski; Sohah N Iqbal; Jennifer Stant; Robert Sciacca; Mark Apfelbaum; Osman R Sayan; James Giglio; Shunichi Homma Journal: J Thromb Thrombolysis Date: 2007-06-12 Impact factor: 2.300
Authors: Anthony Mathur; Doo Sun Sim; Fizzah Choudry; Jessry Veerapen; Martina Colicchia; Tymoteusz Turlejski; Mohsin Hussain; Stephen Hamshere; Didier Locca; Roby Rakhit; Tom Crake; Jens Kastrup; Samir Agrawal; Daniel A Jones; John Martin Journal: ESC Heart Fail Date: 2022-01-18