Effect of thrombolytic therapy on the incidence of early left ventricular infarct expansion in acute anterior myocardial infarction

To determine the incidence of early left ventricular infarct expansion within five days after first anterior ST-segment elevation myocardial infarction and the effect of early thrombolytic therapy on the incidence of early infarct expansion compared with late thrombolytic therapy. In a prospective study of 101 patients [75males and 26 females], with the first attack of acute anterior myocardial infarction, their ages ranged from 40-80 years [mean age: 61.07 +/- 10.78] who had been admitted to the Coronary Care Unit of Hawler Teaching Hospital for the period from July 2007 through to September 2009. Those who received alteplase 3-12 hours were labelled as group-II [52 patients]. The incidence of early left ventricular infarct expansion was diagnosed by 2D-echocardiography and was found to be 17.8%. Group I patients had a lower incidence of early left ventricular infarct expansion [8.16%] compared with group-II [26.92%; p=0.014]. Patients with early left ventricular infarct expansion had a higher frequency rate of left ventricular systolic dysfunction [94.44%] compared to patients without early left ventricular infarct expansion [8.43%; p<0.001]. There was a significant difference in the incidence of in-hospital mortality between the patients who developed early left ventricular infarct expansion [11.1%] compared with patients without early left ventricular infarct expansion [1.2%; p=0.025]. Early reperfusion therapy in acute anterior myocardial infarction can decrease the incidence of early left ventricular infarct expansion, preserve left ventricular systolic function and decrease in-hospital mortality

Influence of thrombolytic therapy on early and long term left ventricular systolic function in patients with ST-segment elevation myocardial infarction

Left ventricular systolic dysfunction complicating acute myocardial infarction are responsible for significant morbidity and mortality. This study to assess the effect of thrombolytic therapy on the left ventricular systolic function during the first week and a year after ST-elevation myocardial infarction. In a study of 56 patients with first ST-Segment elevation myocardial infarction [42 men and 14 women; age range, 42-89 years [mean, 61 +/- 10], who had been admitted to the Coronary Care Unit at Hawler Teaching Hospital from May 2008 to May 2009. study done to assess the left ventricular systolic function during the first week and first year after ST-elevation myocardial infarction. Twenty one patients received tissue plasminogen activator [Alteplase] 12 hour after the onset of symptoms labeled as group-I, the remaining patients [35], had no chance to receive thrombolytic therapy labeled as group II. In group I the mean ejection fraction improved significantly from 51.6 +/- 9.4 during the first week to 55.14 +/- 11, P=0.034, at first year after acute myocardial infarction, while in group II there was no significant difference of mean ejection fraction during the first week [45.97 +/- 12.2] and first year of acute myocardial infarction [46.1 +/- 13.2],P=0.5. Thrombolytic therapy has a beneficial effect on left ventricular systolic function detected by echocardiography at the end of the first year of ST-elevation myocardial infarction

effect of precordial st-segment depression in inferior st-segment elevation myocardial infarction on left ventricular systolic function: two-dimensional echocardiographic study

The importance of precordial ST-segment depression in patients with early inferior ST-segment elevation myocardial infarction remain unclear. Many studies have reported that patients with precordial ST-segment depression appear to have large infarctions. The objectives of this study was to evaluate the effect of precordial ST-segment depression in patients with early inferior ST-segment elevation myocardial infarction on the left ventricular systolic function and left ventricular regional wall abnormalities. Fifty eight patients with first inferior ST-segments elevation myocardial infarction [37 male, 21 femal] their ages ranged from 30-91 year, mean age 60.59 +/- 11.21 who underwent thrombolysis in the Coronary Care Unit of Erbil Teaching Hospital for the period from August 2008 to August 2009 were included in this study. Two-dimensional echocardiography was performed in the first week of acute inferior myocardial infarction. Patients were classified according to the absence [group 1, 30, 51.72%] or presence [group II, 28, 48.28%] of precordial ST- segment depression. Group-ll patients had a higher significant incidence of left ventricular systolic dysfunction [8, 28.57%] than group I [2, 6.67%], P=0.027 .despite thrombolytic therapy [alteplase]. Group-ll patients had higher significant incidence of left ventricular regional wall abnormalities [12, 42.9%] than group-l [3, 10%], P 0.00 .despite thrombolytic therapy [alteplase]. Early two-dimensional echocardiography is recommended for patients with inferior ST-segment elevation myocardial infarction associated with precordial ST-segment depression for the earliest detection of regional wall abnormalities and left ventricular systolic dysfunction