Regression of left ventricular aneurysm after delayed percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction.

Two weeks after acute myocardial infarction (AMI), 23 patients received delayed percutaneous transluminal coronary angioplasty (PTCA) and 14 consecutive randomized selected patients received conservative treatment as a control group. Follow up intravenous and/or intraventricular left cine-ventriculography, as well as radionuclide ejection fraction were performed 6-24 months (mean 11.2 months) after the acute phase. The results showed no significant statistical differences between the two groups for age, sex, Killip class, left ventricular end-diastolic pressure, and medication. The PTCA group showed a significant increase in radionuclide left ventricular ejection fraction, when compared to the control group (20.4 +/- 0.3 vs. 2.05 +/- 1.2; P < 0.05), as well as in the cine-global ejection fraction (32.1 +/- 0.4 vs. 3.44 +/- 1.1; P < 0.05). The dyskinetic area and volume were found also to have greater reduction in the PTCA group than in the control group (-84.7 +/- 1.2 vs. -10.5 +/- 1.1 and -86.1 +/- 1.1 vs. -15.4 +/- 0.9; P < 0.05). There were no significant changes in diastolic or systolic circumferences for both group. In conclusion, delayed PTCA after AMI can reduce the left ventricular dyskinetic area, and improve cine-global ejection fraction. Intravenous first pass left ventriculography is a safe, simple, and reproducible method for evaluating left ventricular remodeling after acute myocardial infarction.