Lack of myocardial perfusion immediately after successful thrombolysis

A predictor of poor recovery of left ventricular function in anterior myocardial infarction

Hiroshi Itoh, Toshio Tomooka, Noriko Sakai, Hisahiro Yu, Yorihiko Higashino, Kenshi Fujii, Tohru Masuyama, Akira Kitabatake, Takazo Minamino

Research output: Contribution to journalArticle

918 Citations (Scopus)

Abstract

Background. We investigated myocardial perfusion dynamics after thrombolysis and its clinical implications. Methods and Results. We studied 39 patients with acute anterior myocardial infarction (AMI). Myocardial contrast echocardiography (MCE) was performed before and immediately after successful reflow with intracoronary injection of sonicated Ioxaglate. The average segmental score by two-dimensional echocardiography (graded 0, normal, to 3, akinetic/dyskinetic) and global ejection fraction (left ventricular ejection fraction, LVEF%) by left ventriculography were measured at 1 day and at 4 weeks after reflow. Hypokinesis in the infarct region was assessed by the centerline method and expressed in terms of standard deviations (regional wall motion [RWM]:SD/chord) of normal. Immediately after reflow, 30 of 39 patients (group A) showed significant contrast enhancement within the risk area. The other nine patients (23%, group B), however, showed the residual contrast defect in the risk area (myocardial no reflow). There were no significant differences in the elapsed time, angiographic collateral grade, and degree of residual stenosis between group A and group B. Before reflow, both groups exhibited similar levels of global and regional left ventricular function. Improvement in global (LVEF, average segmental score) and regional left ventricular function was greater in group A than in group B (average segmental score, 0.44±0.41 versus 0.97±0.36, p

Original languageEnglish
Pages (from-to)1699-1705
Number of pages7
JournalCirculation
Volume85
Issue number5
Publication statusPublished - May 1992
Externally publishedYes

Fingerprint

Left Ventricular Function
Perfusion
Myocardial Infarction
Echocardiography
Ioxaglic Acid
Stroke Volume
Pathologic Constriction
Injections

Keywords

  • Cardiac function
  • Echocardiography, contrast
  • Myocardial reperfusion
  • No reflow phenomenon

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Lack of myocardial perfusion immediately after successful thrombolysis : A predictor of poor recovery of left ventricular function in anterior myocardial infarction. / Itoh, Hiroshi; Tomooka, Toshio; Sakai, Noriko; Yu, Hisahiro; Higashino, Yorihiko; Fujii, Kenshi; Masuyama, Tohru; Kitabatake, Akira; Minamino, Takazo.

In: Circulation, Vol. 85, No. 5, 05.1992, p. 1699-1705.

Research output: Contribution to journalArticle

Itoh, H, Tomooka, T, Sakai, N, Yu, H, Higashino, Y, Fujii, K, Masuyama, T, Kitabatake, A & Minamino, T 1992, 'Lack of myocardial perfusion immediately after successful thrombolysis: A predictor of poor recovery of left ventricular function in anterior myocardial infarction', Circulation, vol. 85, no. 5, pp. 1699-1705.
Itoh, Hiroshi ; Tomooka, Toshio ; Sakai, Noriko ; Yu, Hisahiro ; Higashino, Yorihiko ; Fujii, Kenshi ; Masuyama, Tohru ; Kitabatake, Akira ; Minamino, Takazo. / Lack of myocardial perfusion immediately after successful thrombolysis : A predictor of poor recovery of left ventricular function in anterior myocardial infarction. In: Circulation. 1992 ; Vol. 85, No. 5. pp. 1699-1705.
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