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Updated: Jun 17, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Left ventricular hyperkinesis in acute myocardial infarction and at control angiography after 1 month
R Rummel1, W Rutsch, H Schmutzler
1Department of Cardiology and Pulmology, Universitätsklinikum Rudolf Virchow, Charlottenburg, Freie Universität Berlin, F.R.G.
Insights
Streptokinase treatment for acute myocardial infarction achieved reperfusion in most patients. However, global ejection fraction showed no significant change, as improved regional function was offset by changes in other areas.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Imaging
Background:
- Acute myocardial infarction (AMI) is a leading cause of mortality.
- Early reperfusion therapy aims to limit infarct size and preserve left ventricular function.
- Streptokinase is a thrombolytic agent used in AMI management.
Purpose of the Study:
- To evaluate the effect of intravenous and intracoronary streptokinase on left ventricular function in patients with acute myocardial infarction.
- To assess regional and global left ventricular function changes from the acute phase to follow-up.
- To investigate the impact of infarct-related vessel patency on cardiac function recovery.
Main Methods:
- 154 patients with AMI received streptokinase within 3 hours of symptom onset.
- Contrast ventriculograms were obtained during the acute phase and at 28-day follow-up in 123 patients.
- Regional wall motion analysis used a radial axis system to assess asynergy compared to normal controls.
Main Results:
- Reperfusion was achieved in 79% of patients.
- No significant difference in global ejection fraction (acute: 60.6%, follow-up: 60.4%) was observed.
- Improved regional ejection fraction in hypokinetic areas was counterbalanced by reduced hyperkinesis and regional ejection fraction in contralateral walls.
Conclusions:
- Despite successful reperfusion, streptokinase therapy did not significantly improve global ejection fraction in AMI patients.
- Changes in regional wall motion, including compensatory hyperkinesis reduction, influenced overall cardiac function.
- Maintaining infarct-related vessel patency at follow-up was associated with better, though not statistically significant, global ejection fraction recovery.
Abstract:
One-hundred-and-fifty-four consecutive patients were treated with intravenous and intracoronary streptokinase within 3 h of the onset of acute myocardial infarction. Left ventricular function was determined from contrast ventriculograms obtained in the acute phase and at follow-up at 28 (15-37) days in 123 patients with matched ventriculograms. Regional wall motion analysis was performed with a radial axis system and asynergy determined by comparing percentage radial shortening with findings in ten normal controls. Reperfusion was achieved in 79% of patients. However, there was no significant difference in global ejection fraction between the acute phase (60.6%) and follow-up (60.4%) ventriculograms, although a significant reduction of hypokinetic areas was seen. An increase in regional ejection fraction in anterior (+10%) and inferior (+9%) hypokinesis was counterbalanced by a reduction of incidence (-11%) of hyperkinesis and regional ejection fraction (-10%) in the contralateral wall. In patients with a patent infarct-related vessel at follow-up, no difference in global or regional parameters was found in the acute phase, but at follow-up these patients showed improved regional wall motion with an increase in global ejection fraction (1.6%, n.s.). In patients with occluded vessels at follow-up global ejection fraction decreased (-5.4%, P less than 0.05). The decrease of frequency and extent of hyperkinesis in the clinical course of acute myocardial infarction tends to counterbalance recovery of wall motion in the infarcted region, resulting in little change in global ejection fraction.
