EFFECTS OF ENDOVASCULAR INTERVENTION VS. THROMBOLYSIS ON INTRACARDIAC HEMODYNAMICS AND LEFT VENTRICULAR REMODELLING IN ACUTE MYOCARDIAL INFARCTION
Abstract
Aim. To assess the dynamics of myocardial contractility, geometry, and diastolic function in patients with acute myocardial infarction (AMI) after endovascular intervention vs. thrombolysis. Material and methods. In total, 60 patients (mean age 48,9±2 years) with AMI and ST segment elevation (STEMI) were examined within the first 6 hours from the AMI onset. All participants were divided into three groups: Group I – 22 patients with primary stenting; Group II – 22 patients with the stenting within 24 hours after successful thrombolysis; and Group III – 16 patients with effective thrombolysis and no endovascular intervention. At Day 1 and 7, all participants underwent Doppler echocardiography with the assessment of left ventricular (LV) diastolic function, LV size and volume parameters, total and segmental myocardial contractility (biplane Simpson’s method). Results. According to the comparative analysis results, LV volume parameters did not deteriorate substantially only in Group I. By Day 7, Group III demonstrated a restrictive type of LV diastolic dysfunction, persistent reduction of ejection fraction, and more pronounced disturbances of local LV contractility, compared to Groups I and II. Conclusion. In STEMI patients, primary stenting of the infarct-related artery more effectively prevents early pathological LV remodelling, compared to successful thrombolysis or post-thrombolysis endovascular intervention.
About the Authors
M. Kh. Makoeva
Russian Medical Academy of Post-diploma Education; City Clinical Hospital No. 81, Moscow
Russian Federation
Russian Federation
S. P. Semitko
Russian Medical Academy of Post-diploma Education; City Clinical Hospital No. 81, Moscow
Russian Federation
Russian Federation
A. G. Avtandilov
Russian Medical Academy of Post-diploma Education; City Clinical Hospital No. 81, Moscow
Russian Federation
Russian Federation
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Review
For citations:
Makoeva M.Kh., Semitko S.P., Avtandilov A.G. EFFECTS OF ENDOVASCULAR INTERVENTION VS. THROMBOLYSIS ON INTRACARDIAC HEMODYNAMICS AND LEFT VENTRICULAR REMODELLING IN ACUTE MYOCARDIAL INFARCTION. Russian Journal of Cardiology. 2012;(5):25-29. (In Russ.)
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