Late reperfusion for acute myocardial infarction limits the dilatation of left ventricle without the reduction of infarct size.

• DOI: 10.1161/01.cir.88.6.2565
• Publication Date: 2012-06-12T00:01:09Z
• Authors: A Hirayama; T Adachi; S Asada; M Mishima; S Nanto; H Kusuoka; K Yamamoto; Y Matsumura; M Hori; M Inoue
• Keywords: Reperfusion Therapy

BACKGROUND While previous clinical studies have shown a possible beneficial effect of the reperfusion performed at relatively late phase acute myocardial infarction ("late reperfusion") in preventing left ventricular enlargement, mechanism has not been clarified. METHODS AND RESULTS Of 89 patients with an initial anterior infarction, was successful 69. These 69 were divided into three groups according to time required achieve after onset symptoms: early-reperfused (< 3 hours from reperfusion; n = 22), intermediate-reperfused (3 6 28), and late-reperfused (> 19). The 20 whose infarct-related artery occluded as well 1 month later classified nonreperfused. Infarct size, evaluated defect volume by 201Tl single-photon emission computed tomography onset, 1593 +/- 652 units (mean SD) group, significantly larger (P < .05) than that (1066 546 U) or (372 453 but different nonreperfused group (1736 562 U). Wall motion abnormality index global ejection fraction ventriculography showed did preserve wall function. results indicate earlier decreased size preserved function, whereas onset) limit infarct In contrast, end-diastolic differ among (50 15 mL/m2), (54 14 (53 19 mL/m2) groups; those smaller (68 12 mL/m2; P .05). Left ventriculographic data obtained both chronic 39 volumes increased during course only group. CONCLUSIONS Late appeared prevent dilatation independent limitation size.