Related Experiment Videos
Influence of coronary arterial thrombus location on left ventricular function in acute myocardial infarction
F H Sheehan1, W G Schmidt, E L Bolson
1Cardiovascular Research and Training Center, University of Washington, Seattle 98195.
Insights
Assessing left ventricular hypokinesis in acute myocardial infarction patients reveals proximal left anterior descending artery occlusions cause greater dysfunction. Survival is linked to both infarct and non-infarct region function.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Acute myocardial infarction (AMI) can lead to left ventricular hypokinesis.
- Accurate measurement of hypokinesis extent is crucial for prognosis.
Purpose of the Study:
- To evaluate different methods for measuring the circumferential extent of left ventricular hypokinesis.
- To correlate these measurements with coronary artery occlusion location and 1-year survival in AMI patients.
Main Methods:
- Studied 238 AMI patients undergoing intracoronary streptokinase therapy.
- Measured left ventricular hypokinesis using 5 methods with varying noise filters.
- Correlated measurements with infarct-related coronary artery segment location and 1-year survival.
Main Results:
- All methods showed significant correlation between hypokinesis and left anterior descending (LAD) coronary artery occlusion location.
- No method correlated hypokinesis with right coronary artery (RCA) occlusion location.
- All methods correlated significantly with survival, with the infarct-region-only method performing worst.
- Proximal LAD occlusions resulted in greater hypokinesis than mid- or distal occlusions.
Conclusions:
- The extent of left ventricular hypokinesis in AMI is influenced by the location of LAD occlusion.
- Survival is affected by the function of both infarct and non-infarct regions.
- Complex noise filters offer no advantage over simpler filters for measuring hypokinesis extent.
Abstract:
In 238 patients with acute myocardial infarction studied during intracoronary streptokinase therapy, the circumferential extent of left ventricular hypokinesis was measured by 5 methods and correlated with the location of the infarct-related coronary artery segment and with 1-year survival. Of the 5 methods, 1 focused only on the infarct region, and 4 varied in the complexity of the noise filter. Hypokinetic segment length measurements by all 5 methods correlated significantly with the location of occlusion along the left anterior descending coronary artery. No method yielded measurements that correlated with occlusion location along the right coronary artery. Measurements by all methods correlated significantly with survival, but the method that focused on the infarct region performed least well. Thus, the circumferential extent of hypokinesis in patients with acute myocardial infarction is greater for proximal than mid- or distal occlusions of the left anterior descending but not the right coronary artery. Survival is influenced by the function of periinfarct and noninfarct regions and by the function of the infarct region. Complex noise filters provide no advantage over simpler filters in measuring the extent of hypokinesis.