Non-invasive assessment of reperfusion of the XXXX during coronary thrombolysis and its relation with left ventricular function.

@entity1 @entity2845 @entity1188 @entity158 @entity583
We monitored ST segment continuously for at least 3 h after the beginning of lytic treatment in 103 @entity1 undergoing early coronary thrombolysis for acute @entity583 in order to ascertain whether this technique, which has been shown to be useful to assess recanalization of the @entity1188 , is also able to identify the improvement in left ventricular function associated with successful reperfusion. Global left ventricular function (assessed in the 30 degrees right anterior oblique projection with the area/length method) and @entity1188 zone wall motion (studied with the centerline method) were evaluated at least 4 weeks after the event. Reperfusion was thought to be achieved when ST segment elevation dropped > 50% relative to the most abnormal peak documented at any time in the study. Eighty @entity1 (78%) met the criterium for successful reperfusion (group 1), and 23 (22%) did not (group 2). Both groups had similar clinical and angiographic characteristics. All indexes of global left ventricular function were significantly better in group 1 than in group 2 @entity1 (end-diastolic volume: 176 +/- 51 vs. 209 +/- 76 ml, end-systolic volume: 66 +/- 40 vs. 97 +/- 55 ml, ejection fraction: 65 +/- 13 vs. 57 +/- 11%, respectively, all P < 0.02). Also the severity (-1.6 +/- 1.3 vs. -2.6 +/- 1.01 S.D./chord, respectively, P < 0.001) and the extension of @entity2845 in the @entity1188 zone (number of chords with > 2 S.D.: 13 +/- 16 vs. 28 +/- 17, respectively, P < 0.0001) were less in group 1 than in group 2 @entity1 . Furthermore, in reperfused @entity1 , both global left ventricular function and regional wall motion were better in those admitted < 60 min from onset of @entity158 . In conclusion, @entity1 with rapid ( > 50%) decrease of ST segment elevation have smaller @entity1188 size and better global left ventricular function than @entity1 without electrocardiographic signs of reperfusion as assessed by continuous ST segment monitoring. This suggests that this non-invasive technique is a powerful tool able to identify @entity1 most benefiting from thrombolytic therapy.
