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[Old myocardial infarct: echocardiographic study]

A Butera1, P Pelaggi, G L Palmieri

  • 1Servizio di Cardiologia ed Unità di Terapia, Intensiva Coronarica, Presidio Ospedaliero ASL n. 6, Lamezia Terme.

Giornale Italiano Di Cardiologia
|August 1, 1997
PubMed
Summary

Patients surviving acute myocardial infarction (AMI) show long-term heart damage. Echocardiography reveals that thrombolytic therapy may protect against anatomical and functional damage in very old myocardial infarction (VOMI) survivors.

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Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Many patients survive acute myocardial infarction (AMI), leading to long-term cardiac sequelae.
  • Echocardiography is crucial for understanding anatomical and functional damage in very old myocardial infarction (VOMI) survivors.

Purpose of the Study:

  • To characterize the echocardiographic patterns in VOMI patients.
  • To compare anterior (ant.) vs. inferior (inf.) VOMI and assess the impact of thrombolytic therapy (T+ vs. T-).

Main Methods:

  • Observational study of 136 VOMI patients (mean age 64.4 years, VOMI duration 9.5 years).
  • M-mode and color-Doppler echocardiography assessed left ventricular volumes, ejection fraction (EF), wall motion, and left atrial dimensions.
  • Compared VOMI patients to 100 controls; analyzed differences based on infarction site and thrombolytic treatment.

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Main Results:

  • VOMI patients exhibited enlarged left ventricular volumes (EDVi, ESVi), reduced EF, and increased wall motion abnormalities (WMSI) compared to controls.
  • Anterior VOMI showed more significant volumetric and kinetic changes, including higher rates of aneurysm and scar, than inferior VOMI.
  • Thrombolytic therapy (T+) was associated with better echocardiographic indices and potentially reduced prevalence of aneurysm, thrombus, and mitral regurgitation (MR) long-term.

Conclusions:

  • Very old myocardial infarction (VOMI) leads to persistent left ventricular dilation, reduced ejection fraction, and regional wall motion abnormalities.
  • Anterior VOMI is associated with more pronounced cardiac remodeling than inferior VOMI.
  • Thrombolytic therapy may offer long-term protection against cardiac damage in VOMI survivors, highlighting echocardiography's role in assessment.