Savchenko A P, Smirnov A A, Abugov S A, Leisch F, Kerschner K
Ter Arkh. 1991;63(10):102-6.
As many as 71 patients with the developing large-focal myocardial infarction (MI) were entered into the study. The purpose was to examine the dynamics of the status of the coronary arteries and left ventricular function in MI patients with early recanalization of the infarct-related artery (IRA) as a result of thrombolytic therapy (TLT) and delayed transluminal coronary angioplasty (TCA). Coronary arteriography and left ventriculography were provided 3 times to all the patients: within the first 4 hours of the disease (in combination with TLT), on days 4-6 of the disease (in combination with TCA of the IRA), and after 6 months of observation. It is concluded that the combined use in MI patients of coronary thrombolysis within the first 4 hours of the disease and delayed TCA (on days 4-6 of the disease) ensure steady recovery of IRA patency, with an insignificant residual stenosis of the artery. At the same time the patients demonstrated improvement of local contractility of the deranged compartment of the left ventricle by the 6th month of observation. Restenosis of the recanalized IRA that occurs during 6 months of observation after the interventions performed does not affect the recovery of left ventricular function.
多达71例发展中的大面积局灶性心肌梗死(MI)患者进入该研究。目的是研究因溶栓治疗(TLT)和延迟经皮腔内冠状动脉成形术(TCA)导致梗死相关动脉(IRA)早期再通的MI患者的冠状动脉状况和左心室功能的动态变化。对所有患者进行3次冠状动脉造影和左心室造影:在疾病的前4小时内(与TLT联合)、在疾病的第4 - 6天(与IRA的TCA联合)以及观察6个月后。得出的结论是,在MI患者疾病的前4小时内联合使用冠状动脉溶栓和延迟TCA(在疾病的第4 - 6天)可确保IRA通畅的稳定恢复,动脉残余狭窄不明显。同时,到观察第6个月时,患者左心室紊乱节段的局部收缩力有所改善。干预后6个月观察期内发生的再通IRA再狭窄并不影响左心室功能的恢复。