Regression of left ventricular aneurysm after delayed percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction

Int J Cardiol. 1995 Jan 27;48(1):39-47. doi: 10.1016/0167-5273(94)02206-x.

Abstract

Two weeks after acute myocardial infarction (AMI), 23 patients received delayed percutaneous transluminal coronary angioplasty (PTCA) and 14 consecutive randomized selected patients received conservative treatment as a control group. Follow up intravenous and/or intraventricular left cine-ventriculography, as well as radionuclide ejection fraction were performed 6-24 months (mean 11.2 months) after the acute phase. The results showed no significant statistical differences between the two groups for age, sex, Killip class, left ventricular end-diastolic pressure, and medication. The PTCA group showed a significant increase in radionuclide left ventricular ejection fraction, when compared to the control group (20.4 +/- 0.3 vs. 2.05 +/- 1.2; P < 0.05), as well as in the cine-global ejection fraction (32.1 +/- 0.4 vs. 3.44 +/- 1.1; P < 0.05). The dyskinetic area and volume were found also to have greater reduction in the PTCA group than in the control group (-84.7 +/- 1.2 vs. -10.5 +/- 1.1 and -86.1 +/- 1.1 vs. -15.4 +/- 0.9; P < 0.05). There were no significant changes in diastolic or systolic circumferences for both group. In conclusion, delayed PTCA after AMI can reduce the left ventricular dyskinetic area, and improve cine-global ejection fraction. Intravenous first pass left ventriculography is a safe, simple, and reproducible method for evaluating left ventricular remodeling after acute myocardial infarction.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Algorithms
  • Angioplasty, Balloon, Coronary*
  • Clinical Protocols
  • Female
  • Follow-Up Studies
  • Heart Aneurysm / diagnostic imaging
  • Heart Aneurysm / etiology
  • Heart Aneurysm / physiopathology
  • Heart Aneurysm / therapy*
  • Heart Ventricles
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Radionuclide Ventriculography
  • Remission Induction
  • Stroke Volume
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left