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[Effects of fibrinolysis on late potentials in myocardial infarction]
C de Chillou1, N Sadoul, F Brunotte
1Service de Cardiologie, Hôpital Central, CHRU de Nancy.
Insights
Late potentials after myocardial infarction indicate severity. Fibrinolysis treatment did not reduce their incidence, which correlated with absent coronary reperfusion and reduced left ventricular function.
Area of Science:
- Cardiology
- Electrophysiology
Context:
- Late potentials are significant indicators of myocardial infarction severity.
- Limited research exists on fibrinolysis's impact on late potential incidence post-myocardial infarction.
Purpose:
- To investigate the relationship between fibrinolysis, coronary artery patency, and the occurrence of late potentials following myocardial infarction.
- To assess the correlation between left ventricular function and late potentials in patients treated with fibrinolysis.
Summary:
- Eighty-two patients receiving early fibrinolysis for myocardial infarction were evaluated for late potentials, coronary artery status, and left ventricular ejection fraction.
- Late potentials were observed in 38% of patients with occluded coronary arteries versus 12% with patent arteries (p<0.02).
- A greater decline in left ventricular ejection fraction was noted in patients without achieved reperfusion (p<0.05).
Impact:
- This study indicates that late potential incidence after fibrinolysis is linked to a lack of coronary reperfusion.
- The findings suggest a correlation between absent reperfusion, impaired left ventricular function, and the presence of late potentials post-myocardial infarction.
Abstract:
Late potentials are an index of gravity following myocardial infarction, but there has been little investigation of the effects of fibrinolysis on their incidence. Eighty-two consecutive patients (68 men, 14 women, group men age = 55 +/- 8 years) admitted presenting with a primary infarction and who had received fibrinolytic treatment within the first four hours. Each patient was screened for late potentials, and underwent a coronary artery angiograph and determination of the left ventricular ejaculation fraction (LCEF) following the infarction. The incidence of late potentials was 38% in the patients with an occluded coronary artery (9/24) vs 12% in patients with a permeable artery (7/58) (p less than 0.02). The change in LVEF was greater if reperfusion was not achieved (47 +/- 13% vs 54 +/- 12%, p less than 0.05). This study suggests that following fibrinolysis, the incidence of late potentials is correlated with both an absence of coronary reperfusion and deterioration of left ventricular function.