Author + information
- Received July 23, 1985
- Revision received October 21, 1985
- Accepted October 31, 1985
- Published online April 1, 1986.
- Patrick W. Serruys, MDa,
- Maarten L. Simoons, MD, FACC,
- Haryanto Suryapranata, MD,
- Frank Vermeer, MD,
- William Wijns, MD,
- Marcel van den Brand, MD,
- Frits Bär, MD,
- Chris Zwaan, MD,
- X. Hanno Krauss, MD,
- William J. Remme, MD,
- Jan Res, MD,
- Freek W.A. Verheugt, MD,
- Ronald van Domburg, MS,
- Jacobus Lubsen, MD,
- Paul G. Hugenholtz, MD, FACC,
- for the Working Group on Thrombolytic Therapy in Acute Myocardial Infarction of the Netherlands Interuniversity Cardiology Institute*
- ↵aAddress for reprints: P.W. Serruys, MD, Catheterization Laboratory, Thoraxcenter, Erasmus University, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
The effect of early myocardial reperfusion (within 4 hours after onset of symptoms) on regional left ventricular function in patients with acute myocardial infarction has been quantitated by analysis of segmental wall motion. Of 533 patients randomized either to conventional coronary care unit therapy or to a reperfusion strategy, in 332 high quality angiograms were obtained 2 to 8 weeks after the onset of myocardial infarction. In those assigned to thrombolytic therapy, angiographic data were also available after acute reperfusion. Analysis on an “intention to treat” basis revealed significant preservation of left ventricular function after thrombolytic therapy (ejection fraction 53%) compared with conventional treatment (ejection fraction 47%). In addition, wall motion analysis showed significant improvement of regional function in the infarct zone in both inferior and anterior infarction. In addition, significant changes occurred in regional function of the remote “noninfarct zone” in the acute as well as the chronic stage. It is concluded that improved regional and global left ventricular function can be achieved with early reperfusion and that this is the likely explanation for the reduction of early and late mortality after thrombolysis observed in this study.
- Received July 23, 1985.
- Revision received October 21, 1985.
- Accepted October 31, 1985.
- American College of Cardiology Foundation