The assessment of contractile reserve after thrombolytic therapy for acute myocardial infarction.

Abstract:

:"Stunned" myocardium prevents the assessment of myocardial salvage after streptokinase. In order to unmask "stunning," we sought to evaluate left ventricular inotropic contractile reserve of patients after streptokinase. Radionuclide ventriculograms were obtained in 75 consecutive patients 2 weeks after myocardial infarction, at rest and during intravenous isoproterenol infusion. Resting and isoproterenol-stressed ejection fractions were compared in the patent and closed-infarct vessel groups. Although there was no difference in the resting ejection fractions between the patent group (0.48 +/- 0.02) and the closed group (0.48 +/- 0.02), isoproterenol increased the ejection fractions in the patent group (increase 0.14 +/- 0.01) significantly more than in the closed group (increase 0.06 +/- 0.01) (p less than 0.0001). Thus, despite identical resting ventricular function, the greater inotropic contractile reserve in the patent infarct vessel group suggests that restoration of blood flow in acute myocardial infarction salvages myocardium.

journal_name

Am Heart J

journal_title

American heart journal

authors

Satler LF,Kent KM,Fox LM,Goldstein HA,Green CE,Rogers WJ,Pallas RS,Del Negro AA,Pearle DL,Rackley CE

doi

10.1016/0002-8703(86)90628-9

subject

Has Abstract

pub_date

1986-05-01 00:00:00

pages

821-5

issue

5

eissn

0002-8703

issn

1097-6744

pii

0002-8703(86)90628-9

journal_volume

111

pub_type

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