TY - JOUR
T1 - Relation between the transmural extent of acute myocardial infarction and associated myocardial contractility two weeks after infarction
AU - Elis, Stephen G.
AU - Henschke, Claudia I.
AU - Sandor, Tamas
AU - Wynne, Joshua
AU - Kloner, Robert A.
N1 - Funding Information:
From the DeparbTlents of Medicine, Stanford University Medical Center, Stanford, California, and Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts. This study was supported in part by gants K-23 140 and SCOR H-262 15 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, and funds from the Massachusetts Heart Assoclatlcn, Boston, Massachusetts. Manuscript received August 13, 1964; revised manuscript received February 6, 1985, accepted February 7, 1985. Address for reprints: Stephen G. Ellis, MD, Department of Cardiology, Falk Cardrovascular Research Building, Stanford University Medical Center, Stanford, California 94305.
PY - 1985/5/1
Y1 - 1985/5/1
N2 - To characterize the relation between the transmural extent of acute myocardial infarction (AMI) and associated regional contractility after recovery from ischemia, 11 mongrel dogs underwent occlusion of the proximal left anterior descending coronary artery and were evaluated 2 weeks after infarction. Occlusion was permanent in 5 dogs, and reperfusion was allowed after 2 hours of occlusion in 6 dogs. All dogs had computer-assisted quantitative wallthickening analysis by 2-dimensional echocardiography and infarct localization by the triphenyltetrazolium chloride technique. Percent systolic wall thickening was correlated with the transmural extent of AMI in 40 regions of interest, each measuring aproximately 60 arc degrees in circumference. In 11 non-infarct-containing regions, the mean wall thickening was 59 ± 16% (± standard deviation). In 29 infarct-containing segments (with transmural extent of infarction 11 to 100%) systolic wall thickening ranged from -4% to 47%. Wall thickening and transmural extent of AMI were inversely related. Least-squares regression analysis found the relation to be best described by the logarithmic function, percent wall thickening = 61 - 26 log (percent transmural extent of infarction +1), r = -0.87. The nature of this relation between structure and function suggests that salvage of small amounts of myocardium (transmural extent less than 30 to 40%) by coronary reperfusion or other means may have little effect on systolic myocardial function when compared with the function of transmural infarcts. Alternatively, salvage of more than 40 % of the jeopardized myocardium should be expected to appreciably augment myocardial function.
AB - To characterize the relation between the transmural extent of acute myocardial infarction (AMI) and associated regional contractility after recovery from ischemia, 11 mongrel dogs underwent occlusion of the proximal left anterior descending coronary artery and were evaluated 2 weeks after infarction. Occlusion was permanent in 5 dogs, and reperfusion was allowed after 2 hours of occlusion in 6 dogs. All dogs had computer-assisted quantitative wallthickening analysis by 2-dimensional echocardiography and infarct localization by the triphenyltetrazolium chloride technique. Percent systolic wall thickening was correlated with the transmural extent of AMI in 40 regions of interest, each measuring aproximately 60 arc degrees in circumference. In 11 non-infarct-containing regions, the mean wall thickening was 59 ± 16% (± standard deviation). In 29 infarct-containing segments (with transmural extent of infarction 11 to 100%) systolic wall thickening ranged from -4% to 47%. Wall thickening and transmural extent of AMI were inversely related. Least-squares regression analysis found the relation to be best described by the logarithmic function, percent wall thickening = 61 - 26 log (percent transmural extent of infarction +1), r = -0.87. The nature of this relation between structure and function suggests that salvage of small amounts of myocardium (transmural extent less than 30 to 40%) by coronary reperfusion or other means may have little effect on systolic myocardial function when compared with the function of transmural infarcts. Alternatively, salvage of more than 40 % of the jeopardized myocardium should be expected to appreciably augment myocardial function.
UR - http://www.scopus.com/inward/record.url?scp=0021810170&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(85)90515-6
DO - 10.1016/0002-9149(85)90515-6
M3 - Article
C2 - 3993580
AN - SCOPUS:0021810170
SN - 0002-9149
VL - 55
SP - 1412
EP - 1416
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -