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PubMed2000

Comparison of global and regional left ventricular function assessed by gated-SPECT and 2-D echocardiography.

Left ventricular (LV) function and volumes have major diagnostic and prognostic importance in patients with heart diseases. Those measurements are most commonly obtained with echocardiographic techniques. Recently, with the use of electrocardiographic gating during the acquisition of myocardial perfusion scintigraphy, it has become possible to simultaneously assess LV perfusion, function and volumes. Both technetium-99m labeled agents and thallium-201, the most commonly used tracers for perfusion scintigraphy, can be used for gated perfusion purposes. Many authors compared gated perfusion images to echocardiography, in regard to LV global and segmental wall motion as well as volumes. We performed gated single photon emission computed tomography (SPECT) and echocardiography in 109 consecutive patients (53 male, 56 female, mean age 63 +/- 14 years) within 15 days of each other. Gated tomographic data, including LV volumes, LV ejection fraction and segmental wall motion, were processed using an automatic algorithm whereas echocardiography used standard techniques. To obtain interobserver and intraobserver variability of regional wall motion, we randomly re-analyzed 34 of the 109 gated SPECT studies. The correlations between gated tomography and echocardiography with respect to end-diastolic volume, end-systolic volume and left ventricular ejection fraction were good to excellent (all p < 0.001, r values > or = 0.68) regardless of the use of post-stress or rest/redistribution images, thallium-201 or technetium-99m tracers. The agreement between both techniques, regarding segmental wall motion analysis were also good. Intraobserver and interobserver variability for regional wall motion were good to excellent, with an agreement of 90% and 88%, respectively. Other authors also had similar results in different studies with different populations, tracers, imaging acquisition and processing protocols. Thus, quantitative gated SPECT, using a variety of protocols and with either Tl-201 or Tc-99m tracers, has a good correlation with echocardiography for the measurements of absolute LV volumes and LV global and regional function. This technique is highly reproducible and can be used clinically for those measurements, with the additional advantage that the ventricular performance parameters are obtained from the perfusion images. Furthermore, contrary to echocardiographic techniques used to assess LV volumes and LV function, which are quite labor intensive and more observer-dependent, the gated SPECT technique is nearly totally automatic, and highly reproducible.

Aged↗

PubMed1996

Regional wall motion analysis by dobutamine stess echocardiography to distinguish between ischemic and nonischemic dilated cardiomyopathy.

To distinguish between ischemic and nonischemic dilated cardiomyopathy (DCM), we studied 43 patients with left ventricular dysfunction (15 ischemic and 28 nonischemic detected by coronary angiography) by dobutamine stress echocardiography. At rest, there were more normal segments (p<0.001) and a trend toward more akinetic segments (p, not significant) per ischemic than per nonischemic DCM patient. However, either at rest or with low-dose dobutamine, individual data largely overlapped. At peak dose, in ischemic DCM, regional contraction worsened in many normal or dys-synergic regions at rest (in the latter case after improvement with low-dose dobutamine); in contrast, in nonischemic DCM, further mild improvement was observed in a variable number of left ventricular areas. Thus with peak-dose dobutamine, more akinetic and less normal segments were present per ischemic than per nonischemic DCM patient (both, p<0.001). A value of six or more akinetic segments was 80% sensitive and 96% specific for ischemic DCM. Our data show that analysis of regional contraction by dobutamine stress echocardiography can distinguish between ischemic and nonischemic DCM.

Aged↗

PubMed1989

Regional variation in rat cardiac myosin isoenzymes and ATPase activity after infarction.

Three and 11 wk after coronary artery ligation in rats, the right and left ventricular free wall, septum, and papillary muscles from infarcted and sham-operated hearts were analyzed to determine whether regional variability existed in cardiac actomyosin adenosine triphosphate (ATPase) activity and myosin isoenzymes. Infarction produced a 74% greater right ventricular mass and 19% greater septal mass compared with sham-operated hearts at 3 wk. There was no additional increase in cardiac mass associated with infarction from 3 to 11 wk above that expected for normal growth. Actomyosin ATPase activity and the percent V1 myosin heavy-chain isoenzyme decreased significantly in all regions of the infarcted heart by 3 wk. In addition, the left ventricular and papillary muscle of infarcted hearts exhibited a decrease in percent V1 myosin of 18 and 35%, respectively, compared with the right ventricular free wall and septum. These differences persisted at 11 wk, although no further depression of actomyosin ATPase activity or shift in myosin isoenzyme distribution were observed over the 8-wk period. These results demonstrate that myocardial infarction induces a shift in the myosin isoenzyme distribution and depression in actomyosin ATPase activity of surviving cardiac tissue. Regional variability in myosin isoenzymes is evident by 3 wk, but additional adaptation in cardiac mass and myosin biochemistry do not occur beyond this time.

Actomyosin↗

PubMed2005

Early detection of cardiac dysfunction in thalassemic patients by radionuclide angiography and heart rate variability analysis.

BACKGROUND: Cardiac dysfunction remains the major cause of death in beta-thalassemia. Aim of this study was to assess early myocardial damage in thalassemic patients with no symptoms or echocardiographic evidence of dysfunction at routine monitoring. METHODS: Twenty patients (seven females; median 25 yr [first quartile 22,third quartile 28]) with beta-thalassemia underwent radionuclide angiography (RNA) at rest and during low-dose dobutamine infusion (5-10 gamma/kg/min). Right and left ventricular ejection fractions (EF) were determined by first-pass method and gated equilibrium acquisition, respectively. Twenty-four-hour Holter monitoring with time-domain heart rate variability (HRV) assessment and echocardiographic follow-up (21 months [5,27]) were performed. RESULTS: Eleven patients showed regional wall motion abnormalities at RNA; left ventricular EF, HR and diastolic measurements significantly increased after dobutamine infusion. Patients with abnormal RNA right ventricular EF (n = 8, <0.45) showed lower echocardiographic left ventricular EF at the enrollment (0.54 [0.50,0.61] vs. 0.62 [0.56,0.67], P = 0.02) than those with a normal right ventricular EF. Patients with reduced standard deviation of the averages of RR intervals in all 5-minute periods of entire recording (SDANN) (n = 6, <100 ms), a measure of HRV, had lower echocardiographic left ventricular EF (0.53 [0.49,0.62] vs. 0.62 [0.56,0.66], P = 0.03) and lower fractional shortening (0.28 [0.25,0.32] vs. 0.36 [0.30,0.39], P = 0.003) at the enrollment than those with normal SDANN. No significant association was found between RNA and HRV measurements and follow-up left ventricular function. CONCLUSIONS: Right ventricular dysfunction and abnormal HRV may represent the early features of cardiac disease in thalassemic patients with no evidence of ventricular dysfunction at routine evaluation.

Adult↗

PubMed2001

Relationship of androgens to muscle size and bone mineral density in women with polycystic ovary syndrome.

OBJECTIVE: To investigate the relationship of androgens to regional muscle size and bone mineral density (BMD) in women with polycystic ovary syndrome (PCOS). METHODS: Seventy-one amenorrheic and right-side dominant women with PCOS (mean age +/- standard deviation 28.1 +/- 6.7 years) were enrolled. Baseline characteristics included age, height, weight, and body mass index (BMI). Regional BMD and lean mass were measured by whole-body scanning with dual-energy x-ray absorptiometry. Serum levels of testosterone, dehydroepiandrosterone sulfate (DHEAS), and androstenedione were measured by radioimmunoassay. Correlations between regional BMD and variables were investigated using a Pearson correlation test and multiple regression analysis. RESULTS: Serum testosterone levels correlated significantly with lean mass of the left arm, right arm, trunk, left leg, and right leg (r =.34, P <.05 to r =.50, P <.01). Regional lean mass correlated significantly with respective regional BMD (r =.30, P <.05 to r =.68, P <.001). These relationships remained significant after adjusting for age, height, and weight. Serum testosterone levels were not correlated with BMD of the bilateral arms and lumbar spine. Although serum testosterone levels correlated with leg BMD (r =.34, P <.05 to r =.45, P <.01), significance did not persist after adjusting for respective regional lean mass. CONCLUSION: Testosterone influences regional BMD through increasing regional muscle mass in women with polycystic ovary syndrome.

Adult↗

PubMed1982

Computer-enhanced digital angiography: correlation of clinical assessment of left ventricular ejection fraction and regional wall motion.

We compared computer-enhanced digital angiography (CEDA) following pulmonary injection of 20 ml Renografin-76 (5 ml/sec) to conventional directly injected left ventriculography (LV) in 13 patients undergoing routine diagnostic catheterization. Left ventricular ejection fraction (LVEF) was determined by planimetry from end-diastolic and end-systolic images by two independent angiographers. The correlation coefficient for LVEF (CEDA vs. LV) was r = 0.75 (p less than 0.005) for observer 1 and r = 0.85 (p less than 0.0005) for observer 2. The interobserver variability for LVEF was very low, resulting in a high correlation coefficient (r = 0.91, p less than 0.0005). Three angiographers independently reviewed both the conventional and CEDA images in a random order for assessment of anterior, apical, and inferior regional wall motion, using a 6-point subjective grading system (198 determinations). The interobserver correlation for subjective assessment of regional wall motion by both LV and CEDA was poor (49% for LV and 59% for CEDA, p = NS). These poor correlations were not improved by excluding any region or angiographer from the analysis. The agreement of regional motion assessments between the two techniques was only 40%. To improve reproducibility of wall motion interpretation, an automated analysis program was developed. First the range of normal contraction was defined from pooled literature data. The movement of any segment of the left ventricular wall could then be determined in millimeters and referenced to the normal range. This method eliminated interobserver variability. In the absence of an acceptable standard of segmental wall motion to which this measurement can be compared, the accuracy of this objective format could not be determined. We conclude that CEDA images allow accurate determination of ejection fraction and that the large interobserver variability of subjective regional wall motion analysis can be overcome by employing more objective formats.

Adult↗

PubMedDate not supplied

[Dobutamine stress echocardiography in distinguishing ischemic from nonischemic dilated cardiomyopathy].

INTRODUCTION: The aim of this study was to evaluate the diagnostic accuracy of dobutamine stress echocardiography for detection of coronary artery disease in patients with dilated cardiomyopathy. Detection of regional wall motion abnormalities at rest does not reliably distinguish ischemic from nonischemic cardiomyopathy. MATERIAL AND METHODS: To distinguish between ischemic and nonischemic dilated cardiomyopathy (DCM), we studied 50 patients with left ventricular dysfunction (20 ischemic and 30 nonischemic, detected by coronary angiography) using dobutamine stress echocardiography. Echocardiographic images were obtained at baseline, low and paek dose of dobutamine. Rest and stress left ventricular wall motion scores were derived from analysis of regional wall motion. RESULTS: Dobutamine infusion was terminated after achievement of the target heart rate or maximal protocol dose in 16 (80%) patients with ischemic heart disease and in 23 (73.3%) patients with nonischemic heart disease. At rest, there were more normal segments (p<0.001) and a trend toward more akinetic segments (p, not significant) per ischemic than per nonischemic DCM patients. However, either at rest or with low-dose dobutamine, individual data largely overlapped. At peak dose, in ischemic DCM, regional contraction worsened in many normal or dyssinergic regions at rest (in some cases after inprovement with low-dose dobutamine); in contrast, in nonischemic DCM, further mild impovement was observed in a variable number of left ventricular areas. Thus, with peak-dose dobutamine, more akinetic and less normal segments were present per ishemic than per nonischemic DCM patient (both, p<0.001). A value of six or more akinetic segments was 90% sensitive and 98% specific for ischemic DCM. CONCLUSIONS: Our data show that analysis of regional contraction by dobutamine stress echocardiography can distinguish between.

Cardiomyopathy, Dilated↗

PubMed1999

99mTc-HMPAO regional cerebral blood flow and quantitative electroencephalography in Alzheimer's disease: a correlative study.

UNLABELLED: In this study the neuropsychological status of patients with Alzheimer's disease (AD) was correlated with quantitative electroencephalography (qEEG) and regional cerebral blood flow (rCBF) both in the cortex and in deep gray matter structures. METHODS: Forty-three outpatients (mean age 72.4 +/- 7.5 y) with probable AD underwent 99mTc-hexamethyl propyleneamine oxime SPECT with a brain-dedicated gamma camera and qEEG (relative values) within 1 mo. Preliminary factorial analysis with promax rotation identified four qEEG bands (2-5.5, 6-7.5, 8-11.5 and 12-22.5 Hz, with no distinction as to topography) and six SPECT regions (the two thalami together, the two parietal cortices together, the right temporal cortex, the right hippocampus, the left hippocampus and the remaining cortical areas together) as the variables with highest statistical power. All these variables and the Mini-Mental Status Examination score (MMSE, a sensitive marker of neuropsychological deficit) were processed by a final factorial analysis and multivariate analysis of variance. RESULTS: Both the 2-5.5 Hz and the 8-11.5 Hz powers were correlated with the perfusion level in the parietal regions of interest (ROls) (P = 0.0009), whereas the 2-5.5 Hz power was correlated with the right hippocampal perfusion level (P = 0.007). The MMSE score was significantly correlated with the perfusion level, both in the right (P = 0.006) and in the left (P = 0.004) hippocampal ROls and in the parietal ROls (P = 0.01); moreover, it was correlated with both the 2-5.5 Hz (P = 0.0005) and the 8-11.5 Hz (P = 0.004) power. CONCLUSION: rCBF (bilateral parietal perfusion) and qEEG (especially the slowest frequencies, i.e., 2-5.5 Hz) are confirmed to be good descriptors of AD severity. It is especially noteworthy that bilateral hippocampal CBF was the perfusional index best correlated with the MMSE as well as being significantly correlated to qEEG. Hippocampal SPECT imaging appears to be a promising index to improve characterization of AD in respect to other forms of primary degenerative dementia and may be proposed as a marker for evaluating the effects of pharmacotherapy of AD at the neuronal level.

Aged↗

PubMed1991

Local blood flow and glucose uptake within resting and exercising rabbit skeletal muscle.

A marked regional heterogeneity in blood flow at the level of large arterioles or small arteries is present within single skeletal muscles both in the dog and in the rabbit. A corresponding regional heterogeneity in metabolic activity could explain this phenomenon. We studied the correlation between regional blood flow and regional uptake of glucose within single muscles. Blood flow and glucose uptake were measured using the microsphere technique and the deoxyglucose method, respectively. Blood flow and glucose uptake were determined in 0.25-g regions from resting and stimulated muscles in anesthetized rabbits. Under resting conditions, no correlation between regional blood flow and regional glucose uptake (P greater than 0.05, 12 muscles) was observed. During stimulation, regional blood flow was positively correlated (0.4 less than r less than 0.6, P less than 0.05, 12 muscles) with regional glucose uptake. The coefficients of variation for regional blood flow and regional glucose uptake averaged approximately 0.35 and 0.23, respectively, both at rest and during stimulation. Specific fiber type distributions could not explain either the regional heterogeneity in blood flow or in glucose uptake. We conclude that regional blood flow within single skeletal muscles is not strongly linked to regional uptake of glucose. Both variables show considerable heterogeneity.

Adenosine Triphosphate↗

PubMed1981

Quantitative detection of regional left ventricular contraction abnormalities by two-dimensional echocardiography. I. Analysis of methods.

Different approaches to the quantification of regional left ventricular (LV) function from two-dimensional echocardiographic (2-D echo) images were assessed for their ability to optimize interobserver reproducibility in a heterogeneous patient population and to minimize the variability of regional function observed in a homogeneous normal population. Areas, hemiaxis and perimeter measurements were examined, as were the effect of the degree of image subdivision into halves, quadrants or octants. Each approach was also tested using both a fixed and a floating frame of reference for the definition of a regional-axis system. The area method was consistently superior to either linear method in optimizing both reproducibility and variability. Reproducibility decreased inversely with the degree of subdivision. The axis-system frame of reference had no effect on reproducibility. The floating-axis system yielded the same variability as the fixed system for short-axis sections at the mitral valve level, but slightly less variability for a papillary muscle level section. We conclude that area-based methods are superior for the evaluation of regional LV function with 2-D echo, but the degree of subdivision of the image and the frame of reference chosen do not greatly affect reproducibility or variability and should be chosen based on their performance in a well-defined clinical population.

Diastole↗

PubMed2000

Coronary flow velocity immediately after primary coronary stenting as a predictor of ventricular wall motion recovery in acute myocardial infarction.

OBJECTIVES: The purpose of this study was to examine the relationship between the pattern of coronary blood flow velocity immediately after successful primary stenting and the recovery of left ventricular (LV) wall motion in patients with acute myocardial infarction (AMI). BACKGROUND: It is difficult to predict the recovery of LV wall motion immediately after direct angioplasty in AMI. Recent reports indicate that dysfunctional coronary microcirculation is an important determinant of prognosis for AMI patients after successful reperfusion. METHODS: We measured left anterior descending coronary flow velocity variables using a Doppler guide wire immediately after successful primary stenting in 31 patients with their first anterior AMI. The patients were divided into two groups: those with and those without early systolic reverse flow (ESRF). Changes in LV regional wall motion (RWM) and ejection fraction (EF) at admission and at discharge were compared between the two groups. Coronary flow velocity variables immediately after primary stenting were compared with changes in left ventriculographic indexes. RESULTS: The change in RWM was significantly greater in the non-ESRF group than it was in the ESRF group (0.9 +/- 0.7 vs. -0.1 +/- 0.3 standard deviation/chord, respectively, p < 0.001). The change in EF was also significantly greater in the non-ESRF group than it was in the ESRF group (10 +/- 10 vs. 1 +/- 6%, respectively, p < 0.05). In the non-ESRF group (diastolic to systolic velocity ratio [DSVR] <3.0), the DSVR correlated positively with the change in RWM (r = 0.60, p < 0.005, n = 24) and the change in EF (r = 0.52, p < 0.01). CONCLUSIONS: The coronary flow velocity pattern measured immediately after successful primary stenting is predictive of the recovery of regional and global LV function in patients with AMI.

Aged↗

PubMed2007

Occipital sulci of the human brain: variability and probability maps.

The morphological variation of the sulci of the occipital region of the human brain was examined in both the left and the right hemispheres in 40 normal adult human brains on magnetic resonance images. We identified the occipital sulci and marked their corresponding gray matter voxels on the magnetic resonance images, which had been transformed into the Montreal Neurological Institute standard proportional stereotaxic space in order to construct probability maps. In the medial occipital region, the calcarine sulcus was the longest and most constant sulcus. We identified, in the inferior part of the medial occipital lobe, the lingual sulcus and the posterior collateral sulcus, and, in the superior part, the inferior and superior sagittal sulci of the cuneus. On the lateral surface of the occipital lobe, the lateral occipital, the lunate, and the transverse and inferior occipital sulci were identified. The parieto-occipital fissure and the temporo-occipital incisure were also identified on the lateral and medial surfaces. Finally, the patterns of the occipital sulci and gyri were examined in 20 post-mortem human hemispheres fixed in formalin. Probability maps of the occipital sulci were constructed, which provide a quantitative description of the variability of the sulci in standard stereotaxic space and may be used to identify the location of voxels in other magnetic resonance images transformed into the same streotaxic space. These maps are a useful tool in the study of functional activations related to visual processing.

Adult↗

PubMed1978

Direct method for determining regional myocardial shortening after bypass surgery from radiopaque markers in man.

A new method is described for determining localized epicardial shortening in regions newly perfused after saphenous vein bypass grafting. Four to six radiopaque markers are sutured to the ventricular epicardium in pairs, 2 cm apart and 0 to 3 cm distal to the coronary anastomosis. Shortening fraction and time to onset of shortening are reported in 56 patients examined noninvasively with use of cinefluorography 1 week to 6 months after operation. The right coronary bypass region showed the greatest improvement in shortening fraction in 6 months (from 10.1 to 16.7 percent); the left anterior descending region showed the least (but still significant) improvement (from 8.6 to 11.5 percent). Paradoxical systolic expansion occurred predominantly in the region of the left anterior descending coronary bypass (95 percent of all such occurrences). Measurement error, observer variability and beat to beat variability were less important than the physiologic changes in the postoperative period. This technique is a direct method providing heretofore unavailable follow-up information on localized shortening in newly perfused myocardium after coronary bypass grafting.

Adult↗

PubMed1996

EEG findings in fetal alcohol syndrome and Down syndrome children.

Results from previous studies evaluating the electroencephalograms (EEGs) of infants born to alcoholic mothers suggest that the neonatal EEG may be a sensitive measure of prenatal ethanol exposure. Few studies, however, have examined EEG records of adolescent children with fetal alcohol syndrome (FAS). The present study investigated the resting EEG recordings of 18 matched triads of FAS, Down syndrome, and normal control subjects. Significant reductions in mean power of the alpha frequencies (7.5-12 Hz) were seen for both clinical groups, however, each syndrome appeared to have distinct EEG spectral distributions. Down syndrome children overall had diffuse EEG slowing while the EEG records of the FAS children showed reduced power, particularly in the alpha frequencies in the absence of significant slow activity. In the Down syndrome children, significant decreases in alpha power was seen in posterior cortical regions, whereas FAS children were more affected in the left hemisphere. This study suggests that certain EEG variables may be helpful in characterizing the neurophysiology of FAS.

Adolescent↗

PubMed1989

Variable and constant regions in African swine fever virus DNA.

An analysis of the SalI restriction pattern of African swine fever virus DNA showed that the SalI recognition sites did not change after more than 100 virus passages in porcine macrophages. The virus strain BA71V, obtained from the virus isolate BA71 by adaptation to grow in VERO cells, differed from the nonadapted virus in two deletions with a length of 2.5 and 7 kb located close to the DNA ends. A restriction analysis of several virus clones obtained from a naturally infected pig revealed length heterogeneity in both variable regions. A comparison of SalI restriction maps from 23 African swine fever virus field isolates (8 African, 11 European, and 4 American) has shown that the virus genome consists of a central region with a constant length of about 125 kb and two variable regions located close to the DNA ends with a length of 38-47 kb for the left DNA end, and 13-16 kb for the right DNA end. The total length of ASF virus DNA varied between 178 (BA71) and 189 (MOZ64) kb. The 23 African swine fever virus isolates were classified into five groups, according to the arrangement of the SalI sites in the central region. Four groups contained only African isolates, whereas all the European and American isolates belonged to the same group. This distribution of isolates suggests that all non-African virus field isolates have a common origin.

Africa↗

PubMed1989

Changes in the restriction endonuclease patterns of four modified-live infectious bovine rhinotracheitis virus (IBRV) vaccines after one passage in host animal.

Four genomically different bovine herpes virus 1 (BHV 1) vaccines were used to inoculate BHV 1-negative heifers. Restriction endonuclease analysis (REA) of virus isolates from animals during acute infection, after reactivation of virus from latency, and after reactivation followed by superinfection, showed that changes occurred in the BHV 1 genome after one passage in the host animal. Furthermore, the changes varied according to the tissue from which virus was isolated. Southern probe analyses identified the left terminus of the unique long fragment and the inverted repeats as regions of the genome where variability was most often observed. It was concluded that, when REA is used in the diagnostic differentiation of BHV 1 isolates, caution must be applied in the interpretation of results.

Animals↗

PubMed1997

Anatomical variability in the cortical representation of first and second language.

Functional magnetic resonance imaging was used to assess inter-subject variability in the cortical representation of language comprehension processes. Moderately fluent French-English bilinguals were scanned while they listened to stories in their first language (L1 = French) or in a second language (L2 = English) acquired at school after the age of seven. In all subjects, listening to L1 always activated a similar set of areas in the left temporal lobe, clustered along the left superior temporal sulcus. Listening to L2, however, activated a highly variable network of left and right temporal and frontal areas, sometimes restricted only to right-hemispheric regions. These results support the hypothesis that first language acquisition relies on a dedicated left-hemispheric cerebral network, while late second language acquisition is not necessarily associated with a reproducible biological substrate. The postulated contribution of the right hemisphere to L2 comprehension is found to hold only on average, individual subjects varying from complete right lateralization to standard left lateralization for L2.

Adult↗

PubMed1983

Intracoronary thrombolysis in evolving myocardial infarction. Sequential angiographic analysis of left ventricular performance.

Since November 1979 left ventricular angiography and coronary arteriography have been performed in 80 patients with evolving acute myocardial infarction in order to attempt coronary recanalisation by local streptokinase infusion. The average delay between the onset of symptoms and streptokinase infusion was 3.6 hours. Thrombolysis was successful in 64% of cases. No serious complications related to the procedure were noted. Of the 12 patients in cardiogenic shock, recanalisation was achieved in only four, of whom two survived. To evaluate the left ventricular salvage resulting from early recanalisation the last 58 patients had a second left ventricular angiogram and further coronary arteriograms 21 +/- 10 days later and 16 patients had a third study three months later. From the left ventricular angiogram in the right anterior oblique projection the ejection fraction and two graphic variables of regional wall motion were computed quantifying the hypokinetic zone. Patients were divided into two groups, according to the patency of the infarct related artery at the second control: group 1 consisted of 28 patients with successful recanalisation confirmed, and group 2 of 30 patients in whom no recanalisation was achieved or secondary reocclusion had occurred. At the second study the ejection fraction was unchanged in group 1 but had significantly decreased in group 2. Regional wall motion improved in group 1 and worsened in group 2, more so in patients without recanalisation than in those in whom secondary reocclusion had occurred. The third study showed a further decrease in ejection fraction in group 2. A progressive decrease in percentage residual stenosis was observed in group 1. This sequential angiographic study confirms the partial myocardial salvage resulting from early coronary recanalisation during acute myocardial infarction.

Adult↗