Japanese

Effects of coronary collateral circulation in evolving myocardial infarction:as a major determinant of preserving myocardial function after intracoronary thrombolysis Yoshihiko Saito 1 , Masao Yasuno 1 , Moriharu Ishida 1 , Shigeki Endo 1 , Katsuhiro Suzuki 1 , Masaaki Takahashi 1 1Division of Internal Medicine, Shizuoka Rosai Hospital pp.571-574
Published Date 1985/4/15
DOI https://doi.org/10.11477/mf.1404204659
  • Abstract
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The effects of coronary collateral circulation were assessed in 26 patients with acute myocardial infarction, who underwent intracoronary thrombo-lytic therapy within 8 hours after the onset of symptoms. These patients were divided into four groups based on the development of collateral circulation in the acute phase and the results of intracoronary thrombolytic therapy. Group A con-sisted of 10 patients who had well-developed col-lateral circulation and successful thrombolysis with sustained patency. Group B consisted of 5 patients who had less-developed or no collateral circulation and successful thrombolysis with sustained patency. Group C consisted of 5 patients who had well-developed collateral circulation and unsuccessful thrombolysis. Group D consisted of 6 patient who had less-developed or no collateral circulation and unsuccessful thrombolysis. Patients in group A had a significant increase in regional wall shortening from the acute phase to the late phase (from 4.4±8.8% to 30.0±9.4%; p<0.001), whereas patients in other groups did not. In the repeat left ventriculo-graphy, patients in group A had much higher regional wall shortening compared with patients in group B, C, and D (A vs. B, 30.0±9.4% vs.9.9±7.8%; p<0.01: A vs. C or D, 30.0±9.4% vs. 2.0±2.8% or 2.4±7.6% ; p<0.001). More-over, there was no significant difference in regional wall shortening among patients in group B, C, and D. This study indicates that well-developed collateral circulation can prolong the time course of myocardial cell death, therefore only patients with well-developed collateral circulation can be expected to improve in regional wall shortening by means of intracoronary thrombolytic therapy.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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