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. 1991;18(2):110–115.

Deterioration in Left Ventricular Performance during Early Coronary Angioplasty after Thrombolysis

Evidence for Myocardial Salvage

Michael S Norell 1, John P Lyons 1, Simon S Davies 1, Adam D Timmis 1, Raphael Balcon 1
PMCID: PMC324976  PMID: 15227492

Abstract

To investigate the effects of controlled coronary artery reocclusion after successful thrombolysis, we studied 15 patients during early elective angioplasty of the patent infarct-related artery. Eight patients underwent left anterior descending artery dilation, and the other 7 had right coronary artery dilation. In 13 cases, ST-segment elevation developed during balloon occlusion. In all 15 cases, intravenous digital subtraction left ventriculography during balloon inflation showed that the ejection fraction decreased at least 5% (mean decrease, from 60% to 47%), despite preexisting Q waves overlying the infarct territory in 5 patients. Balloon inflation resulted in decreased apical segmental shortening in all 8 patients who underwent left anterior descending artery dilation; likewise, balloon inflation produced impairment of inferior-wall contraction in all 7 patients who had right coronary artery dilation.

In this setting, a deterioration in left ventricular performance indicates that the restoration of coronary patency with thrombolysis has resulted in myocardial salvage. In patients with Q waves, such deterioration suggests that this electrocardiographic abnormality does not necessarily indicate a completed infarction. (Texas Heart Institute Journal 1991;18:110-5)

Keywords: Angioplasty, transluminal percutaneous coronary

Keywords: coronary circulation

Keywords: coronary disease

Keywords: heart ventricle

Keywords: myocardial contraction

Keywords: myocardial infarction

Keywords: streptokinase

Keywords: thrombolytic therapy

Keywords: ventricular function, left

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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