[Coronary thrombolytic therapy in acute XXXX : time dependence of beneficial effects assessed by two-dimensional echocardiography].

@entity1 @entity662 @entity910 @entity2845 @entity583
To elucidate the effects of coronary thrombolytic therapy in acute @entity583 , we observed serially the degree of left ventricular (LV) wall motion immediately after on day 1, and on days 7, 14, 21 and 28 after thrombolytic therapy, in 22 @entity1 with @entity583 . Base-line coronary arteriography revealed significant lesions in the proximal portions of the left anterior descending artery of all the @entity1 . The @entity1 were categorized according to results of thrombolytic therapy as Group I-a: seven @entity1 with spontaneous or successful recanalization within three hours of onset of @entity662 ; Group I-b: nine @entity1 with successful recanalization between three and seven hours, with a mean of 4.8 hours from onset; and Group II: six @entity1 in whom thrombolytic therapy was unsuccessful and infarct-related vessels remained totally occluded. The LV wall motion index (WMI) was defined as the sum of point scores for the degrees of regional wall motion at nine segments on serial two-dimensional echocardiograms, and used for quantitative assessments of LV function. Results were as follows: On day 1, immediately after thrombolytic therapy, the WMI of Group I-a was smaller than that of Group II. However, there was no significant difference between Groups I-a and I-b and between Groups I-b and II. These findings suggest that LV function cannot be recovered immediately after recanalization of occluded arteries unless recanalization occurs exceptionally early. Percent improvement of the WMI from days 1 to 28 in Group I-a, 65 +/- 14%, was significantly greater than that in Group I-b, 31 +/- 18%. However, Group II did not show significant improvement in the WMI. The WMI in Group I-a decreased significantly from days 1 to 7 (9.0 +/- 1.6 vs 7.1 +/- 1.8, p less than 0.05); whereas, the WMI in Group I-b showed no significant decrease until day 21. On day 1, the regional wall motion of the antero-apical wall was @entity2845 or @entity910 in all @entity1 studied. On day 28, it improved in six of seven @entity1 in Group I-a, while it remained @entity2845 or @entity910 in all @entity1 in Groups I-b and II.(ABSTRACT TRUNCATED AT 400 WORDS)
