Left and right ventricular function after streptokinase reperfusion: assessment by gated blood pool scans

Twenty-three patients with acute anterior or inferior myocardial infarction (AMI, IMI) were investigated by gated blood pool scans at a mean 4.9 h after reperfusion and 10 days later. Eighteen (78%) successful reperfusion cases were divided into two groups; reperfusion in less than 4 h (Rp less than 4 h, n = 9) and reperfusion in more than 4 h (Rp greater than 4 h, n = 9) from the onset of chest pain. As control group, gated blood pool scans were also performed in the early hours following infarction in an additional 42 patients who received conventional treatments. Rp less than 4 h demonstrated significant improvement of mean LVEF in AMI (from 39.5 +/- 3.3 to 50.3 +/- 3.1%, p less than 0.01) and IMI (from 54.6 +/- 4.3 to 60.4 +/- 5.8%, p less than 0.01). Improvement of initially abnormal segments was noticed in 68% of AMI and 65% of IMI by quantitative wall motion analysis, while Rp greater than 4 h showed only slight improvement of LVEF and regional wall motion compared to Rp less than 4 h. On the other hand, the control group showed no significant change in left ventricular performance and regional wall motion. In patients with AMI, RVEF remained within normal range. In IMI, whether reperfused or not, the RVEF showed moderate improvement. In conclusion, these studies indicated that the time of reperfusion and location of infarction may influence functional recovery after streptokinase reperfusion.