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Updated: Aug 29, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Effect of thrombolysis (streptokinase) on left ventricular function during acute myocardial infarction
Insights
Successful reperfusion after acute myocardial infarction significantly improves left ventricular function. Early left ventricular ejection fraction is a key predictor of recovery, regardless of thrombolysis timing or infarct location.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Acute myocardial infarction (AMI) poses a significant threat to left ventricular (LV) function.
- Thrombolytic therapy is a cornerstone in managing AMI, aiming to restore coronary blood flow.
- Assessing changes in LV function post-thrombolysis is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the impact of successful coronary reperfusion on left ventricular (LV) function in patients with acute myocardial infarction.
- To determine factors influencing the recovery of LV ejection fraction (EF) after thrombolytic therapy.
Main Methods:
- Prospective trial involving 192 patients with AMI treated with intracoronary or intravenous streptokinase.
- First-pass radionuclide ejection fraction (EF) measured early (within 24 hours) and late (10-14 days) post-admission.
- Analysis of factors including time to lysis, infarct location, and initial ECG findings on EF change.
Main Results:
- In patients with successful reperfusion (n=68), mean EF increased from 39% to 47%.
- Patients with unsuccessful reperfusion (n=36) showed a smaller EF increase (38% to 42%).
- No significant influence of time to lysis, infarct location, or Q waves on the extent of EF change was observed.
Conclusions:
- Successful reperfusion significantly enhances left ventricular ejection fraction in AMI patients.
- Initial left ventricular ejection fraction is the primary predictor of subsequent functional improvement.
- Thrombolysis effectiveness in improving LV function is primarily linked to successful reperfusion rather than specific treatment parameters like timing or infarct location.
Abstract:
One hundred ninety-two consecutive patients with acute myocardial infarction were enrolled in a prospective trial of coronary thrombolysis in which either intracoronary or intravenous streptokinase was administered. First-pass radionuclide ejection fraction (EF) was measured early (within 24 hours of admission) and late (10 to 14 days after admission) to assess changes in left ventricular (LV) function. In 68 patients in whom reperfusion was successful, mean EF increased from 39 +/- 11% early to 47 +/- 13% late. In 36 patients in whom reperfusion was not successful, the mean EF increase was significantly smaller (from 38 +/- 10% to 42 +/- 11%, p less than 0.025). Patients in whom reperfusion was successful were then grouped according to extent of LV functional change. The extent of EF change (delta EF) was not significantly influenced by time to lysis at intervals up to 7 hours (delta EF = 9.1 +/- 10% at 2 to 3 hours, 8.7 +/- 12% at 3 to 4 hours, 10 +/- 10% at 4 to 5 hours, and 7.0 +/- 10% at 5 to 7 hours; difference not significant [NS]), location of the infarct (delta EF = 8.9 +/- 11% for inferior and 5.7 +/- 8.0% for anterior, NS), or presence of Q waves on the initial electrocardiogram (delta EF = 8.8 +/- 11% in patients with and 7.8 +/- 9.9% in patients without Q waves). Only the initial EF was predictive of subsequent EF change.(ABSTRACT TRUNCATED AT 250 WORDS)
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