[Echocardiographic monitoring of acute myocardial infarct following intracoronary streptolysis treatment].

Two-dimensional echocardiography is helpful in the detection of wall motion abnormalities and in the evaluation of time courses of regional function due to interventions. Of 301 patients with acute myocardial infarction treated with selective intracoronary infusion of streptokinase, 229 (76%) revealed a totally occluded infarct related vessel at the first angiography. In 64 patients a two-dimensional apical long-axis view of good technical quality could be obtained after admission, on the 1st, 2nd and 3rd day and again in the 4th to 6th week and the 9th to 14th month after the acute intervention. The collective was divided into two subgroups according to the different time interval between the beginning of symptoms of infarction and the reopening of the occluded vessel. 35 patients had a total time of occlusion of less than 4 hours (group A), while in 29 others this time exceeded 4 hours or thrombolysis was unsuccessful (group B). Using a computer system, the center of gravity of the end-systolic frame of the left ventricle was used as an inner fix point. 10 end-systolic and end-diastolic area segments were constructed. Regional wall motion was determined as a percentual change of the enclosed area, normalized to the end-diastolic area (% delta F). The ejection fraction was calculated using a disc method. In group A the ejection fraction increased from initially 46 +/- 9% to 51 +/- 8%, 52 +/- 8% (p less than 0.05) and 53 +/- 8% (p less than 0.01) on the 1st, 2nd and 3rd day, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)