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Immediate hemodynamic effects of thrombolytic therapy on the ischemic myocardium

R L Quigley1, M J Khandekar, S S Switzer

  • 1Department of Surgery, Guthrie Clinic, Sayre, Pennsylvania 18840, USA.

Catheterization and Cardiovascular Diagnosis
|July 1, 1996
PubMed

Insights

Thrombolytic agents like streptokinase, urokinase, and rtPA temporarily impair cardiac function. This study found no significant differences in acute hemodynamic effects between these agents in normal or ischemic hearts.

Area of Science:

  • Cardiology
  • Pharmacology
  • Biomedical Engineering

Background:

  • Thrombolytic agents are crucial for restoring coronary artery perfusion and limiting myocardial infarction size.
  • Extensive research exists on the systemic effects, rheology, and late performance impacts of streptokinase (SK), urokinase (UK), and recombinant tissue plasminogen activator (rtPA).
  • However, acute hemodynamic consequences immediately post-administration remain understudied.

Purpose of the Study:

  • To evaluate the acute hemodynamic effects of thrombolytic therapy on normal and ischemic myocardium.
  • To compare the immediate cardiac performance impacts of different thrombolytic agents.

Main Methods:

  • Utilized an isolated Langendorf rodent heart preparation.
  • Quantified cardiac performance by measuring cardiac output, coronary blood flow, and blood pressure.
  • Administered thrombolytic agents to assess immediate hemodynamic changes.

Main Results:

  • All tested thrombolytic agents (SK, UK, rtPA) transiently impaired cardiac performance.
  • No statistically significant differences were observed in the acute hemodynamic effects among the agents.
  • The impact on cardiac performance was similar in both normal and ischemic myocardium.

Conclusions:

  • The acute hemodynamic effects of thrombolytic agents are transient and similar across agents.
  • Current data do not support favoring one thrombolytic agent over another based on primary myocardial performance.
  • Further research may explore other aspects of thrombolytic therapy beyond acute hemodynamics.

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