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[The effect of systemic thrombolytic therapy on left ventricular contractile function and on the tolerance for
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Successful thrombolytic therapy with avelysin in macrofocal myocardial infarction (MI) patients led to myocardial reperfusion in 20 individuals. These patients demonstrated improved exercise tolerance and myocardial contractility post-MI.
Area of Science:
- Cardiology
- Pharmacology
Context:
- Macrofocal myocardial infarction (MI) presents significant challenges in patient recovery and long-term prognosis.
- Systemic thrombolytic therapy is a critical intervention for acute MI, aiming to restore blood flow to ischemic heart muscle.
Purpose:
- To evaluate the impact of systemic thrombolytic therapy with avelysin on myocardial reperfusion and subsequent clinical outcomes in patients with macrofocal MI.
- To assess the effects of successful reperfusion on myocardial contractility, hemodynamics, exercise tolerance, and cardiac reserves over a 10-month follow-up period.
Summary:
- Thirty-six patients with macrofocal MI received systemic thrombolytic therapy with avelysin within 6 hours of symptom onset.
- Patients were categorized into two groups: those achieving myocardial reperfusion (n=20) and those without (n=16).
- Assessments included echocardiography, radiocardiography, and bicycle ergometry to evaluate myocardial contractility, hemodynamics, exercise tolerance, and cardiac reserves at hospital discharge and 10-month follow-up.
Impact:
- Myocardial reperfusion following avelysin therapy significantly improved exercise tolerance and myocardial contractility in MI patients.
- Patients with successful reperfusion maintained enhanced myocardial contractility and exhibited substantially higher exercise tolerance at 10-month follow-up compared to initial assessments.
- These findings underscore the positive influence of myocardial reperfusion on the long-term recovery and functional capacity of patients with macrofocal myocardial infarction.
Abstract:
36 patients with macrofocal myocardial infarction (MI) underwent systemic thrombolytic therapy with avelysin (500,000-750,000 U) within the disease first 6 hours. By the results of the treatment 2 groups were identified: patients with thrombolysis and myocardial reperfusion (n = 20), patients free of reperfusion manifestations (n = 16). The patients were examined in hospital and outside 10 months after MI development: myocardial contractility and hemodynamics were assessed at echocardiography and radiocardiography, exercise tolerance, coronary and myocardial cardiac reserves using bicycle ergometry. Better exercise tolerance and myocardial contractility were shown both in hospital and in follow-up by patients with myocardial reperfusion. According to the follow-up findings, myocardial contractility was such the same as that on postinfarction week 4, exercise tolerance was much higher than at the first examination. Thus, myocardial reperfusion affects positively the parameters studied in MI patients.