Effects of percutaneous transluminal coronary angioplasty on segmental left ventricular function in patients with acute myocardial infarction.
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概要
- 論文の詳細を見る
In order to investigate the usefulness of percutaneous transluminal coronary angioplasty (PTCA) on subsequent left ventricular (LV) function in patients with acute myocardial infarction (AMI), regional ejection fraction (REF) was calculated from the left ventriculogram and compared in the acute and chronic phases (4 weeks after infarction) in 19 successful cases of PTCA (group A). In addition, 15 successful cases of intracoronary thrombolysis (PTCR) (group R) and 14 unsuccessful cases (group U) were also analyzed in this study.From the results, the following points were elucidated.(1) REF of group A in the chronic phase showed a significant increase compared to that in the acute phase (10±18% vs 20±19%, p<0.01), and this was similar to that observed in group R (9±19% vs 21±16%, p<0.01).(2) All cases in group A showed a significant increase in REF (p<0.02), if recanalization occurred within 3 hours after the onset of AMI. Some cases in the 3-6 hour recanalization group showed a decrease in REF.(3) In group A, only patients with subtotal occlusion on the initial coronary angiogram showed a significant increase in REF 4 weeks later (p<0.01), whereas patients with total occlusion on the initial coronary angiogram showed no significant increase in REF.(4) In group A, only patients recanalized between 3 and 6 hours showed a severe degree of prolonged contrast staining immediately after successful recanalization following PTCA.Thus, chronic phase regional wall motion was markedly improvedby PTCA in those cases with residual flow. In contrast, abrupt recanalization after PTCA might causally decrease regional wall motion due to hemorrhagic infarction, if it is performed in cases with total occlusion.
著者
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Kurogane Hiroyuki
Department Of Cardiology Himeji Cardiovascular Center
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Fujino Motohiro
Department Of Cardiology Himeji Cardiovascular Center
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Nakatani Makoto
Department of Cardiology, Himeji Cardiovascular Center
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Tomimoto Shinobu
Department of Cardiology, Himeji Cardiovascular Center
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Kawakami Kenta
Department of Cardiology, Himeji Cardiovascular Center
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Takeuchi Motoshi
Department Of Cardiology Himeji Cardiovascular Center
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Imai Naoaki
Department Of Chemistry Graduate School Of Science Osaka University
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Kawakami Kenta
Department Of Cardiology Himeji Cardiovascular Center
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Yamada Shigenobu
Department Of Cardiology Himeji Cardiovascular Center
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Yoshida Yutaka
Deparlment Of Internal Medicine School Of Medicine Kobe University
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SUNAKO Michitoshi
Department of Cardiology, Himeji Cardiovascular Center
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MINAMIJI Katsumi
Department of Cardiology, Himeji Cardiovascular Center
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IMAI Naoaki
Department of Cardiology, Himeji Cardiovascular Center
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Yamada Shigenobu
Department of Applied Chemisty, Faculty of Engineering, Yamagata University
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