Regional wall motion improvement after coronary thrombolysis with recombinant XXXX : importance of coronary angioplasty.

@entity1 @entity662 @entity1456 @entity1188 @entity583
To evaluate functional recovery in 20 consecutive @entity1 with @entity583 who received recombinant tissue-type plasminogen activator, serial two-dimensional echocardiograms were performed before and immediately after @entity1456 administration and at 1 and 10 days postinfarction. @entity1456 was administered intravenously (17 @entity1 ) or by intracoronary infusion (3 @entity1 ) after angiographic confirmation of total occlusion. Reperfusion, documented by angiography, occurred in 13 of the 20 @entity1 . The mean time from onset of @entity662 to thrombolysis was 5.1 +/- 1.1 hours. Echocardiograms were evaluated for regional function with a visual semiquantitative scoring system by two independent observers who had no knowledge of @entity1 identity, temporal sequence, therapy or effect of therapy. There was no immediate or 24 hour improvement in wall motion. At day 10 compared with pretreatment, 28 of 33 reperfused @entity1188 zone segments versus 6 of 20 nonreperfused @entity1188 segments demonstrated improved wall motion (p = 0.01). This improvement did not relate to time from onset of @entity662 to successful thrombolysis. Of reperfused @entity1188 zone segments in the distribution of coronary artery balloon dilation, 19 of 23 segments exhibited improvement versus 7 of 17 (reperfused, no angioplasty) and 6 of 20 (nonreperfused, no angioplasty) segments (p = 0.001). Infarct zone segments reperfused at the time of ongoing @entity662 demonstrated functional recovery compared with segments reperfused in the absence of @entity662 (18 of 23 versus 10 of 20, respectively; p = 0.05). Thus, in this uncontrolled series, there was echocardiographically detectable improvement in function of reperfused @entity1188 segments 10 days after coronary thrombolysis with recombinant @entity1456 .
