Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1980 Sep;44(3):271–279. doi: 10.1136/hrt.44.3.271

Site and severity of coronary narrowing and infarct size in man.

M Hori, M Inoue, N Ohgitani, K Tsujioka, H Abe, S Fukui, T Minamino
PMCID: PMC482397  PMID: 7426184

Abstract

The relation between the site and severity of coronary artery lesion and infarct size was investigated in 59 patients with acute myocardial infarction. All patients had no prior myocardial infarction and had at least one significant coronary narrowing (greater than or equal to 75%) in one of the major coronary arteries or in the first diagonal branch. Left ventriculography and selective coronary arteriography were performed on average 2.2 months after the onset of infarction to identify the site and severity of coronary narrowing and to assess the extent of the non-contracting segment (akinetic, dyskinetic, or aneurysmal). Thirty-four of 59 patients were studied enzymatically and total CK released was taken as an indication of infarct size. Non-contracting segment and total CK released in group L-I (narrowing proximal to the first diagonal branch) were significantly larger than those in group L-II (a coronary lesion distal to the branch). The data also indicate that the perfusion area of the first diagonal branch is as large as that of the left anterior descending artery below the first diagonal branch. In contrast to left anterior descending artery disease, the involvement of the right ventricular branch did not significantly influence the infarct size. However, infarct size was significantly larger in eight patients with the left ventricular branch of the right coronary artery supplying the predominantly large area of posterior wall of the left ventricle than in nine patients with small left ventricular branches. It was also shown that the severity of coronary narrowing does not correlate with the infarct size in either left anterior descending or right coronary artery disease.

Full text

PDF
271

Selected References

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

  1. Ahmed S. H., el-Rakhawy M. T., Abdalla A., Harrison R. G. A new conception of coronary artery preponderance. Acta Anat (Basel) 1972;83(1):87–94. doi: 10.1159/000143849. [DOI] [PubMed] [Google Scholar]
  2. Austen W. G., Edwards J. E., Frye R. L., Gensini G. G., Gott V. L., Griffith L. S., McGoon D. C., Murphy M. L., Roe B. B. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation. 1975 Apr;51(4 Suppl):5–40. doi: 10.1161/01.cir.51.4.5. [DOI] [PubMed] [Google Scholar]
  3. BURSTEIN J. Myocardial infarction; acute course and prognosis in one hundred and twenty-seven cases of varied extent and localization electrocardiographically determined with the aid of multiple unipolar leads. Acta Med Scand Suppl. 1953;285:1–83. [PubMed] [Google Scholar]
  4. Capone R. J., Most A. S., Sydik P. A. Precordial ST segment mapping. A sensitive technique for the evaluation of myocardial injury? Chest. 1975 May;67(5):577–582. doi: 10.1378/chest.67.5.577. [DOI] [PubMed] [Google Scholar]
  5. Corr P. B., Pearle D. L., Hinton J. R., Roberts W. C., Gillis R. A. Site of myocardial infarction. A determinant of the cardiovascular changes induced in the cat by coronary occlusion. Circ Res. 1976 Dec;39(6):840–847. doi: 10.1161/01.res.39.6.840. [DOI] [PubMed] [Google Scholar]
  6. Feild B. J., Russell R. O., Jr, Moraski R. E., Soto B., Hood W. P., Jr, Burdeshaw J. A., Smith M., Maurer B. J., Rackley C. E. Left ventricular size and function and heart size in the year following myocardial infarction. Circulation. 1974 Aug;50(2):331–339. doi: 10.1161/01.cir.50.2.331. [DOI] [PubMed] [Google Scholar]
  7. Gensini G. G., Buonanno C. Coronary arteriography. A study of 100 cases with angiographically proved coronary artery disease. Dis Chest. 1968 Aug;54(2):90–99. doi: 10.1378/chest.54.2.90. [DOI] [PubMed] [Google Scholar]
  8. Hori M., Inoue M., Fukui S., Shimazu T., Mishima M., Ohgitani N., Minamino T., Abe H. Correlation of ejection fraction and infarct size estimated from the total CK released in patients with acute myocardial infarction. Br Heart J. 1979 Apr;41(4):433–440. doi: 10.1136/hrt.41.4.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Inoue M., Hori M., Fukui S., Abe H., Minamino T. Evaluation of evolution of myocardial infarction by serial determinations of serum creatine kinase activity. Br Heart J. 1977 May;39(5):485–492. doi: 10.1136/hrt.39.5.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. James T. N. The coronary circulation and conduction system in acute myocardial infarction. Prog Cardiovasc Dis. 1968 Mar;10(5):410–449. doi: 10.1016/s0033-0620(68)80002-7. [DOI] [PubMed] [Google Scholar]
  11. Kalbfleisch H., Hort W. Quantitative study on the size of coronary artery supplying areas postmortem. Am Heart J. 1977 Aug;94(2):183–188. doi: 10.1016/s0002-8703(77)80278-0. [DOI] [PubMed] [Google Scholar]
  12. Maroko P. R., Kjekshus J. K., Sobel B. E., Watanabe T., Covell J. W., Ross J., Jr, Braunwald E. Factors influencing infarct size following experimental coronary artery occlusions. Circulation. 1971 Jan;43(1):67–82. doi: 10.1161/01.cir.43.1.67. [DOI] [PubMed] [Google Scholar]
  13. Mullen D. C., Posey L., Gabriel R., Singh H. M., Flemma R. J., Lepley D., Jr Prognostic considerations in the management of left ventricular aneurysms. Ann Thorac Surg. 1977 May;23(5):455–460. doi: 10.1016/s0003-4975(10)64166-5. [DOI] [PubMed] [Google Scholar]
  14. Norris R. M., Whitlock R. M., Barratt-Boyes C., Small C. W. Clinical measurement of myocardial infarct size. Modification of a method for the estimation of total creatine phosphokinase release after myocardial infarction. Circulation. 1975 Apr;51(4):614–620. doi: 10.1161/01.cir.51.4.614. [DOI] [PubMed] [Google Scholar]
  15. Pfeffer M. A., Pfeffer J. M., Fishbein M. C., Fletcher P. J., Spadaro J., Kloner R. A., Braunwald E. Myocardial infarct size and ventricular function in rats. Circ Res. 1979 Apr;44(4):503–512. doi: 10.1161/01.res.44.4.503. [DOI] [PubMed] [Google Scholar]
  16. Proudfit W. L., Shirey E. K., Sones F. M., Jr Selective cine coronary arteriography. Correlation with clinical findings in 1,000 patients. Circulation. 1966 Jun;33(6):901–910. doi: 10.1161/01.cir.33.6.901. [DOI] [PubMed] [Google Scholar]
  17. Schaper W., Remijsen P., Xhonneux R. The size of myocardial infarction after experimental coronary artery ligation. Z Kreislaufforsch. 1969 Aug;58(8):904–909. [PubMed] [Google Scholar]
  18. Sobel B. E., Bresnahan G. F., Shell W. E., Yoder R. D. Estimation of infarct size in man and its relation to prognosis. Circulation. 1972 Oct;46(4):640–648. doi: 10.1161/01.cir.46.4.640. [DOI] [PubMed] [Google Scholar]
  19. WOODS J. D. Relative ischaemia in the hypertrophied heart. Lancet. 1961 Apr 1;1(7179):696–698. doi: 10.1016/s0140-6736(61)91723-8. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES