Skip Navigation

European Heart Journal 1997 18(8):1261-1268;
Copyright © 1997 by the European Society of Cardiology.
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Meneveau, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Meneveau, N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1997 The European Society of Cardiology

Influence of late reopening of the infarct-related artery on left ventricular remodelling after myocardial infarction

N. Meneveau*,, J.-P. Bassand*, C. Bauters{dagger}, J.-Y. Rozand{ddagger}, J.-L. Petit§, D. Beurrier||, G. Grollier, F. Andre**, A. Vahanian{dagger}{dagger}, J.-F. Viel{ddagger}{ddagger} and on behalf of the IRIS Study Group

*Hôpital Universitaire Saint-Jacques Besançon
{dagger}Hôpital Cardiologique Lille
{ddagger}Hôpital Universitaire Sabourin Clermont-Ferrand
§Hôpital de la Tronche Grenoble
||Hôpital Universitaire Brabois Nancy
¶Hôpital Universitaire de la Côte de Nacre Caen
**Hôpital du Bocage Dijon
{dagger}{dagger}Hôpital Universitaire Tenon Paris
{ddagger}{ddagger}Département d'informatique et statistique, Hôpital Saint-Jacques Besançon, France

Received 15 October 1996; accepted 16 October 1996.

Correspondence: N. Meneveau, Hôpital Universitaire Saint-Jacques, 2, Place Saint-Jacques, 25030, Besançon Cedex, France

Abstract

AIM: This trial was undertaken to assess the impact of late reopening of the infarct-related artery on left ventricular remodelling in post-myocardial infarction patients.

METHODS: One hundred and fifty seven patients with recent myocardial infarction were routinely submitted to delayed (second week) catheterization. They also underwent systematic angioplasty of a significantly narrowed infarct-related artery with a suitable anatomy, or reopening of a totally occluded infarct-related artery, and repeat follow-up catheterization after 4 months. Changes in left ventricular ejection fraction, left ventricular volumes, and percent of regional hypokinesia were assessed over the study period.

RESULTS: One hundred and thirty-two patients had two interpretable left ventriculograms and two interpretable coronary angiograms. At initial angiography, 56 out of 96 patients with a patent infarct-related artery were successfully submitted to percutaneous coronary angioplasty, of whom 25 had restenosis and eight had total reocclusion at follow-up angiography. Percutaneous transluminal coronary angioplasty was not attempted in the remaining 40 patients due to unsuitable anatomy in 18 or a nonsignificant lesion in 22. The infarct-related artery was totally occluded in 36 patients at initial angiography, and successfully reopened by means of angioplasty in 19, of whom seven showed a reocclusion at follow-up angiography. The independent predictors of left ventricular enlargement, identified by means of multivariate regression analysis, were initial stroke volume index <40 ml.m–2 (odds ratio=6·3, 95% confidence interval=[2·5; 16·6]), initial end-systolic volume index >50 ml.m–2 (odds ratio=7·1, 95% confidence interval=[1·5; 25·8]), anterior infarct location (odds ratio=4·1, 95% confidence interval=[1·4; 11·5]) and reocclusion of the infarct-related artery (odds ratio=7·3, 95% confidence interval=[1·3; 27·3]). Angioplasty of a patent but significantly narrowed infarct-related artery was not found predictive.

CONCLUSION: This study demonstrates that reocclusion of a previously open infarct-related artery, as well as the initial low stroke volume index, enlarged end-systolic volume index and anterior infarct location are independent predictors of long-term left ventricular enlargement. These results emphasize the impact of long-term sustained patency of the infarct-related artery on the prevention of left ventricular dysfunction. The need for a larger randomized trial is recognised.

Key Words: Left ventricular remodelling • coronary patency • coronary angioplasty • coronary reopening


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur J Heart FailHome page
M. Prech, S. Grajek, A. Marszalek, M. Lesiak, M. Jemielity, A. Araszkiewicz, T. Mularek-Kubzdela, and A. Cieslinski
Chronic infarct-related artery occlusion is associated with a reduction in capillary density. Effects on infarct healing
Eur J Heart Fail, June 1, 2006; 8(4): 373 - 380.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Gaudino, F. Alessandrini, F. Glieca, N. Luciani, C. Cellini, C. Pragliola, M. Morelli, F. Girola, and G. Possati
Effect of surgical revascularization of a right coronary artery tributary of an infarcted nonischemic territory on the outcome of patients with three-vessel disease: A prospective randomized trial
J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 435 - 439.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.