Importance of coronary collaterals for restoration of left ventricular function after intracoronary thrombolysis

• Published in: The American journal of cardiology Vol. 55; no. 11; pp. 1259 - 1263
• Main Authors: Saito, Yoshihiko, Yasuno, Masao, Ishida, Moriharu, Suzuki, Katsuhiro, Matoba, Yoshiki, Emura, Masahito, Takahashi, Masaaki
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.1985
• Subjects: Acute Disease; Adult; Aged; Arterial Occlusive Diseases - diagnostic imaging; Arterial Occlusive Diseases - drug therapy; Arterial Occlusive Diseases - physiopathology; Cardiac Output - drug effects; Chronic Disease; Collateral Circulation - drug effects; Coronary Circulation - drug effects; Coronary Disease - diagnostic imaging; Coronary Disease - drug therapy; Coronary Disease - physiopathology; Female; Humans; Injections, Intra-Articular; Male; Middle Aged; Radiography; Stroke Volume - drug effects; Urokinase-Type Plasminogen Activator - pharmacology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(85)90485-0

In an evaluation of the role of coronary collaterals in the early period of acute myocardial infarction (AMI), 30 patients with acute total coronary occlusion treated with intracoronary thrombolysis 2 to 8 hours after the onset of symptoms were studied. Only 13 patients with well-developed collaterals in the early period of AMI and successful thrombolysis showed improvement of global and regional ejection fraction (EF) from the acute phase to the chronic phase (global EF from 50% to 71%, p < 0.001; regional EF from 25.4% to 49.2%, p < 0.001). In patients with no or less well-developed collaterals and successful thrombolysis, global and regional EF were similar to those in patients in whom thrombolysis was unsuccessful. Among the 19 patients with successful thrombolysis, there was no significant correlation between the duration of ischemia and the improvement of regional EF (r = −0.03, difference not significant). These data suggest that the extent of coronary collateral vessels in the early period of AMI is an important determinant of restoration of left ventricular function after intracoronary thrombolysis.