Left ventricular systolic function in myocardial infarction survivors treated with primary angioplasty, thrombolysis of angioplasty preceded by thrombolysis

Abstract

Background: Acute myocardial infarction (AMI) may be treated with thrombolysis, primary angioplasty or a combination of both methods. Preservation of left ventricular systolic function is an important goal of treatment.
Aim: To assess whether the mode of treatment of AMI influences left ventricular systolic function measured 6 months after AMI.
Methods: In a group of 108 patients who survived AMI, an echocardiographic examination was performed 6 months afterwards. Ejection fraction, wall motion score index, asynergy area index, infarcted wall motion score index and apical segments motion score index were measured. Patients were divided into three groups: those treated with thrombolysis only, treated with angioplasty or those who underwent angioplasty preceded by thrombolysis.
Results: Global left ventricular systolic function was similar in all three groups. Compared to the two remaining groups, the group treated with combined therapy had significantly worse indexes of infarcted wall motion score and apical segments motion score. This group also included a significantly higher number of patients with akinetic or dyskinetic apical segments.
Conclusions: Echocardiographic examination of global left ventricular systolic function in MI survivors performed 6 months after AMI, reveals similar values regardless of the method used for AMI treatment. However, segmental systolic function in the area of infarcted wall and apical segments is significantly more altered in patients treated with angioplasty preceded by thrombolysis than in other analysed patients.