Skip to main content
SpringerLink
Log in

Linksventrikuläre Funktion beim Patienten mit akutem Myokardinfarkt nach intrakoronarer oder systemischer Thrombolysebehandlung

  • Conference paper
Thrombolytische Therapie des akuten Herzinfarkts

  • 16 Accesses

Zusammenfassung

Das linksventrikuläre Pumpversagen gilt heute als die Haupttodesursaehe beim akuten Myokardinfarkt. Das Ausmaß des Pumpversagens ist abhängig von der Infarktgröße. Eine Begrenzung der Infarktgröße dürfte demnach auf die Prognose und die Lebensqualität der Infarktpatienten einen entscheidenden Einfluß haben. Nachdem De Wood et al. [1] erstmals bei Patienten den Nachweis erbringen konnten, daß dem akuten Myokardinfarkt ein thrombotischer Koronararterienverschluß zugrunde liegt, wuchs das Interesse, durch Thrombolysebehandlung den Blutfluß in dem von der Nekrose bedrohten Myokardareal wiederherzustellen und damit die Infarktgröße zu begrenzen. Begleitet wurde diese klinische Forschung von tierexperimentellen Untersuchungen zur Reperfusion, durch die wichtige Erkenntnisse über den zeitlichen Ablauf von Myokardischämie und Nekrose gewonnen wurden [2–4].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. DeWood MA, Spores J, Notske R et al. (1980) Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med 303:897–902

    Article  PubMed  CAS  Google Scholar 

  2. Kloner RA, Braunwald E (1980) Observations on experimental myocardial ischemia. Cardio vase Res 14:371

    Article  CAS  Google Scholar 

  3. Maroko PR, Libby P, Ginks WR (1972) Coronary artery reperfusion. Early effects on local myocardial function and the extent of myocardial necrosis. J Clin Invest 51:2710

    Article  PubMed  CAS  Google Scholar 

  4. Reimer KA, Lowe JE, Rasmussen MM et al. (1977) The wave front phenomenon of ischemic cell death. 1. Myocardial size vs. duration of coronary occlusion in dogs. Circulation 56:786

    PubMed  CAS  Google Scholar 

  5. Ganz W, Buchbinder N, Marcus H et al. (1981) Intracoronary thrombolysis in evolving myocardial infarction. Am Heart J 101:4

    Article  PubMed  CAS  Google Scholar 

  6. Rentrop P, Blanke H, Karsch KR et al. (1981) Selective intracoronary thrombolysis in acute myocardial infarction and unstable angina pectoris. Circulation 63:307

    Article  PubMed  CAS  Google Scholar 

  7. Mathey DG, Kuck KH, Tilsner V et al. (1981) Nonsurgical coronary artery recanalization in acute transmural myocardial infarction. Circulation 63:489

    Article  PubMed  CAS  Google Scholar 

  8. Schröder R, Biamino G, von Leitner ER et al. (1983) Intravenous short-term infusion of streptokinase in acute myocardial infarction. Circulation 67:536

    Article  PubMed  Google Scholar 

  9. Reimer KA (1980) Myocardial infarct size. Arch Pathol Lab Med 104:225–230

    PubMed  CAS  Google Scholar 

  10. Lie JT, Paierolero PC, Holley KE et al. (1975) Macroscopic enzyme - Mapping verification of large, homogenous, experimental myocardial infarcts of predictable size and location in dogs. J Thorac Cardio vase Surg 69:599–604

    CAS  Google Scholar 

  11. Schaper W, Remijsen P, Xhoneux R (1969) The size of myocardial infarction after experimental coronary artery ligation. Z Kreislaufforsch 58:904

    PubMed  CAS  Google Scholar 

  12. Wachers FJT, Becker AE, Samson G et al. (1977) Location and size of acute transmural myocardial infarction estimated from Thallium-201 scintiscans. A clinicopathological study. Circulation 72:72–78

    Google Scholar 

  13. Niess GS, Logic JR, Rüssel RO jr et al. (1979) Usefulness and limitations of Thallium-201 myocardial scintigraphy in delineating location and size of prior myocardial infarction. Circulation 59:1010–1019

    PubMed  CAS  Google Scholar 

  14. Sobel BE, Bresnahan GF, Shell WE et al. (1972) Estimation of infarct size in man and its relation to prognosis. Circulation 46:640–649

    PubMed  CAS  Google Scholar 

  15. Ideker RE, Wagner GS, Ruth WK et al. (1982) Evaluation of a QRS scoring system for estimating myocardial infarct size. II. Correlation with quantitative anatomic findings for anterior infarcts. Am J Cardiol 49:1604–1614

    Article  PubMed  CAS  Google Scholar 

  16. Falsetti HL, Marcus ML, Kerber RE et al. (1981) Quantification of myocardial ischemia and infarction by left ventricular imaging. Circulation 63:747–751

    Article  PubMed  CAS  Google Scholar 

  17. Homans DC, Asinger R, Elsperger KJ et al. (1985) Regional function and perfusion at the lateral border of ischemic myocardium. Circulation 71:1038–1047

    Article  PubMed  CAS  Google Scholar 

  18. Gibbons EF, Hogan RD, Franklin TD et al. (1985) The natural history of regional dysfunction in a canine preparation of chronic infarction. Circulation 71:394–402

    Article  PubMed  CAS  Google Scholar 

  19. Lieberman AN, Weiss JL, Jugdutt BI et al. (1981) Two-dimensional echocardiography and infarct size: Relationship of regional wall motion and thickening to the extent of myocardial infarction in the dog. Circulation 63:739–746

    Article  PubMed  CAS  Google Scholar 

  20. Sheehan FH, Bolson EL, Dodge HT et al. (1986) Advantages and applications of the centerline method for characterizing regional ventricular function. Circulation 74:293–305

    Article  PubMed  CAS  Google Scholar 

  21. Herman MV, Gorlin R (1969) Implications of left ventricular asynergy. Am J Cardiol 23:538–547

    Article  PubMed  CAS  Google Scholar 

  22. Kaul S, Pandian NG, Gillam LD et al. (1986) Contrast echocardiography in acute myocardial ischemia. III. An in vivo comparison of the extent of abnormal wall motion with the area at risk for necrosis. J Am Coll Cardiol 2:383

    Article  Google Scholar 

  23. Klein MD, Herman MV, Gorlin R (1967) A hemodynamic study of left ventricular aneurysm. Circulation 35:614–630

    PubMed  CAS  Google Scholar 

  24. Page DL, Caulfield JB, Kastor J A et al. (1971) Myocardial changes associated with cardiogenic shock. N Engl J Med 285:133–137

    Article  PubMed  CAS  Google Scholar 

  25. Reimer KA, Jennings RB. Energy metabolism in the reversible and irreversible phases of severe moycardial ischemia. In: Kjekshus J, Lund-Johansen J, Helle-Berg S (eds) Myocardial ischemia. Oslo p 19

    Google Scholar 

  26. Jennings RB, Steenbergen C, jr (1985) Nucleotide metabolism and cellular damage in myocardial ischemia. Ann Rev Physiol 47:727–749

    Article  CAS  Google Scholar 

  27. Reimer KA, Lowe JE, Jennings RB (1977) Effect of the calcium antagonist verapamil on necrosis following temporary coronary artery occlusion in dogs. Circulation 55:581–587

    PubMed  CAS  Google Scholar 

  28. Heyndrickx GR, Millard RW, McRitchie RJ et al. (1975) Regional myocardial functional and electrophysiological alterations after brief coronary artery occlusion in conscious dogs. J Clin Invest 56:978–985

    Article  PubMed  CAS  Google Scholar 

  29. Lavallee M, Cox D, Patrick TA et al. (1983) Salvage of myocardial function by coronary artery reperfusion 1, 2, and 3 h after occlusion in conscious dogs. Circ Res 53:235–247

    PubMed  CAS  Google Scholar 

  30. Pairolero P, Hallermann FJ, Ellis F jr (1970) Left ventriculogram in experimental myocardial infarction. Radiolgy 95:311–316

    CAS  Google Scholar 

  31. Reduto LA, Smalling RW, Freund GC et al. (1981) Intracoronary infusion of streptokinase in patients with acute myocardial infarction: effects of reperfusion on left ventricular performance. Am J Cardiol 48:403–409

    Article  PubMed  CAS  Google Scholar 

  32. Khaja F, Walton J A jr, Brymer JF et al. (1983) Intracoronary fibrinolytic therapy in acute myocardial infarction. N Engl J Med 308:1306–1311

    Article  Google Scholar 

  33. Charuzi Y, Beeder C, Marshall LA et al. (1984) Improvement in regional and global left ventricular function after intracoronary thrombolysis: assessment with two-dimensional echocardiography. Am J Cardiol 53:662–665

    Article  PubMed  CAS  Google Scholar 

  34. Wackers FJ, Berger HJ, Weinberg MA et al. (1982) Spontaneous changes in left ventricular function over the first 24 h of acute myocardial infarction: implications for evaluating early therapeutic interventions. Circulation 66:748–754

    Article  PubMed  CAS  Google Scholar 

  35. Nemerovaski M, Shah PK, Piehler M et al. (1982) Radionuclide assessment of sequential changes in left and right ventricular function following first acute transmural myocardial infarction. Am Heart J 104:709–717

    Article  Google Scholar 

  36. Feild BJ, Russel O, Dowling JT et al. (1972) Regional left ventricular performance in the year following moycardial infarction. Circulation 46:679–689

    PubMed  CAS  Google Scholar 

  37. Corday E, Kaplan L, Meerbaum S et al. (1975) Consequences of coronary arterial occlusion on remote myocardium: effects of occlusion and reperfusion. Am J Cardiol 36:385–394

    Article  PubMed  CAS  Google Scholar 

  38. Theroux P, Franklin D, Ross J jr et al. (1974) Regional myocardial function during acute coronary artery occlusion and its modification by pharmacologic agents in the dog. Circ Res 35:896–907

    PubMed  CAS  Google Scholar 

  39. Sheehan FH, Mathey DG, Schofer J et al. (1983) Effect of interventions in salvaging left ventricular function in acute myocardial infarction: a study of intracoronary streptokinase. Am J Cardiol 52:431–438

    Article  PubMed  CAS  Google Scholar 

  40. Stack RS, Phillips HR III, Grierson DS et al. (1983) Functional improvement of jeopardized myocardium following intracoronary streptokinase infusion in acute myocardial infarction. J Clin Invest 72:34–95

    Article  Google Scholar 

  41. Sheehan FH, Szente A, Mathey DG et al. (1985) Assessment of left ventricular function in acute myocardial infarction: The relationship between global ejection fraction and regional wall motion. Eur Heart J 6 [Suppl E]:117–125

    Google Scholar 

  42. Hooghoud TEH, Serruys PW, Reiber JHC et al. (1982) The effect of recanalization of the occluded coronary artery in acute myocardial infarction on left ventricular function. Eur Heart J 3:416–421

    Google Scholar 

  43. Serruys PW, Simoons ML, Suryapranata H et al. (1986) Preservation of global and regional left ventricular function after early thrombolysis in acute myocardial infarction. J Am Coll Cardiol 7:729–742

    Article  PubMed  CAS  Google Scholar 

  44. Wyne J, Sayres M, Maddox DE et al. (1980) Regional left ventricular function in acute myocardial infarction: evaluation with quantitative radionuclid ventriculography. Am J Cardiol 45:203–209

    Article  Google Scholar 

  45. Tennant R, Wiggers CJ (1935) Effect of coronary occlusion on myocardial contraction. Am J Physiol 112:351–361

    Google Scholar 

  46. Maroko PR, Libby P, Ginsk WR et al. (1972) Coronary artery reperfusion. I. Early effects on local myocardial function and the extent of myocardial necrosis. J Clin Invest 51:2710–2716

    Article  PubMed  CAS  Google Scholar 

  47. Constantini C, Corday E, Lang TW et al. (1975) Revascularization after 3 hours of coronary arterial occlusion: effects on regional cardiac metabolic function and infarct size. Am J Cardiol 36:368–384

    Article  Google Scholar 

  48. Raizner AE, Tortoledo FA, Verani MS et al. (1985) Intracoronary thrombolytic therapy in acute myocardial infarction: a prospective, randomized, controlled trial. Am J Cardiol 55:301–308

    Article  PubMed  CAS  Google Scholar 

  49. Smalling RW, Fuentes F, Freund GC et al. (1982) Beneficial effects of intracoronary thrombolysis up to eighteen hours after onset of pain in evolving myocardial infarction. Am Heart J 104:912–920

    Article  PubMed  CAS  Google Scholar 

  50. Sheehan FH, Mathey DG, Schofer J et al. (1985) Factors determining recovery of left ventricular function following thrombolysis in acute myocardial infarction. Circulation 71:1121–1128

    Article  PubMed  CAS  Google Scholar 

  51. Kennedy JW, Gensini GG, Timmis GC et al. (1985) Acute myocardial infarction treated with intracoronary streptokinase: a report of the Society for Cardiac Angiography. Am J Cardiol 55:871–877

    Article  PubMed  CAS  Google Scholar 

  52. Gruppo Italiano per lo Studio della Streptokinasi Nell Infarto Miocardico (GISSI) (1986) Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1:397

    Google Scholar 

  53. Kennedy JW, Ritchie JL, Davis KB et al. (1985) Western Washington randomized trial of intracoronary streptokinase in acute myocardial infarction: 12-month follow-up report. N Engl J Med 312:1073–1078

    Article  PubMed  CAS  Google Scholar 

  54. Kalbfleisch H, Hort W (1977) Quantitative study on the size of coronary artery supplying areas postmortem. Am Heart J 94:183–188

    Article  PubMed  CAS  Google Scholar 

  55. Miller RR, Olson HG, Vismara LA et al. (1976) Pump dysfunction after myocardial infarction: importance of location, extent and pattern of abnormal left ventricular segmental contraction. Am J Cardiol 37:340–344

    Article  PubMed  CAS  Google Scholar 

  56. Kumpuris AG, Quinones MA, Kanon D et al. (1980) Isolated stenosis of left anterior descending or right coronary artery: relation between site of stenosis and ventricular dysfunction and therapeutic implications. Am J Cardiol 46:13–20

    Article  PubMed  CAS  Google Scholar 

  57. Stadius ML, Maynard C, Fritz JK et al. (1985) Coronary anatomy and left ventricular function in the first 12 hours of acute myocardial infarction: the Western Washington randomized intracoronary streptokinase trial. Circulation 72:292–301

    Article  PubMed  CAS  Google Scholar 

  58. Schwartz H, Leiboff RH, Bren GB et al. (1984) Temporal evolution of the human coronary collateral circulation after myocardial infarction. J Am Coll Cardiol 4:1088–1093

    Article  PubMed  CAS  Google Scholar 

  59. Williams DO, Amsterdam EA, Miller RR et al. (1976) Functional significance of coronary collateral vessels in patients with acute myocardial infarction: Relation to pump performance, cardiogenic shock and survival. Am J Cardiol 37:345–351

    Article  PubMed  CAS  Google Scholar 

  60. Cortina A, Ambrose JA, Prieto-Granada J et al. (1985) Left ventricular function after myocardial infarction: clinical and angiographic correlations. J Am Coll Cardiol 5:619–624

    Article  PubMed  CAS  Google Scholar 

  61. Blanke H, Cohen M, Karsch KR et al. (1985) Prevalence and significance of residual flow to the infarct zone during the acute phase of myocardial infarction. J Am Coll Cardiol 5:827

    Article  PubMed  CAS  Google Scholar 

  62. Leiboff RH, Katz RJ, Wasserman AG et al. (1984) A randomized, angiographically controlled trial of intracoronary streptokinase in acute myocardial infarction. Am J Cardiol 53:404–407

    Article  PubMed  CAS  Google Scholar 

  63. Schuler G, Schwarz F, Hofmann M et al. (1984) Thrombolysis in acute myocardial infarction using intracoronary streptokinase: assessment by thallium-201 scintigraphy. Circulation 69:338–349

    Article  Google Scholar 

  64. Rogers WJ, Hood WP jr, Mantle JA et al. (1984) Return of left ventricular function after reperfusion in patients with myocardial infarction: importance of subtotal stenoses or intact collaterals. Circulation 69:338–349

    Article  PubMed  CAS  Google Scholar 

  65. Ong L, Reister P, Coromilas J et al. (1983) Left ventricular function and rapid release of creatine kinase MB in acute myocardial infarction. N Engl J Med 309:1–6

    Article  PubMed  CAS  Google Scholar 

  66. Merx W, Bethge C, Effert S et al. (1981) Supraselective fibrinolysis in acute myocardial infarction. Bibl Haematologica 47:205–212

    Google Scholar 

  67. Smalling RW, Fuentes F, Matthews MW et al. (1983) Sustained improvement in left ventricular function and mortality by intracoronary streptokinase administration during evolving myocardial infarction. Circulation 68:131–138

    Article  PubMed  CAS  Google Scholar 

  68. Koh D, Mitten S, Stewart D et al. (1979) Comparison between computerized quantitative coronary angiography and clinical interpretation (abstract). Circulation 60 [Suppl II]: 160

    Google Scholar 

  69. Harrison DG, Ferguson DW, Collins SM et al. (1984) Rethrombus after reperfusion with streptokinase: Importance of geometry of residual lesions. Circulation 69:991–999

    Article  PubMed  CAS  Google Scholar 

  70. Bache RJ, McHale PA, Greenfield JC jr (1977) Transmural myocardial perfusion during restricted coronary inflow in the awake dog. Am J Physiol 232:H 645–651

    Google Scholar 

  71. Akaishi M, Weintraub WS, Schneider RM et al. (1986) Coronary reserve affects myocardial blood flow distribution after reperfusion. J Am Coll Cardiol 7:206 A

    Google Scholar 

  72. Stahl LD, Aversano TR, Becker LC (1986) Selective enhancement of function of stunned myocardium by increased flow. Circulation 74:843–851

    Article  PubMed  CAS  Google Scholar 

  73. Topol EJ, Weiss JL, Brinker JA et al. (1985) Regional wall motion improvement after coronary thrombolysis with recombinant tissue plasminogen activator: importance of coronary angioplasty. J Am Coll Cardiol 6:426–433

    Article  PubMed  CAS  Google Scholar 

  74. Verani MS, Tortoledo FE, Batty JW et al. (1985) Effect of coronary artery recanalization on right ventricular function in patients with acute myocardial infarction. J Am Coll Cardiol 5:1029–1035

    Article  PubMed  CAS  Google Scholar 

  75. Bourdillon PD, Timmis G, Terris S et al. (1985) Improved regional left ventricular function after coronary angioplasty in acute myocardial infarction: comparison with intracoronary streptokinase (abstract). Circulation 72 [Suppl III]:309

    Google Scholar 

  76. Timmis GC, O’Neill W, Bakalyar D et al. (1985) Effect of reperfusion adequacy on ventricular function versus infarction size (abstract). Circulation 72 [Suppl III]:308

    Google Scholar 

  77. Schroder R, Biamino G, Leitner ERY et al. (1983) Intravenous short-term infusion of streptokinase in acute myocardial infarction. Circulation 67:536–548

    Article  PubMed  CAS  Google Scholar 

  78. Mathey DG, Schofer J, Sheehan FH et al. (1985) Intravenous urokinase in acute myocardial infarction. Am J Cardiol 55:878–882

    Article  PubMed  CAS  Google Scholar 

  79. Mathey DG, Schofer J, Becher H et al. (1985) How can we increase the proportion of patients who benefit from thrombolysis? Eur Heart J 6 [Suppl E]:229–233

    Google Scholar 

  80. O’Neill W, Timmis GC, Bourdillon PD et al. (1986) A prospective randomized trial of intracoronary streptokinase versus coronary angioplasty for acute myocardial infarction. N Engl J Med 314:812–818

    Article  PubMed  Google Scholar 

Download references

Authors
  1. D. G. Mathey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Schofer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Sheehan
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Cardiology, The Royal Infirmary, EH3 9YW, Edinburgh, Scotland, UK

    David P. de Bono M.D., F.R.C.P.

  2. Department of Cardiology, University Hospital, F-37044, Tours Cedex, France

    Mireille L. Brochier M.D.

  3. Akademisch Ziekenhuis, Thoraxcentrum, Erasmus University Rotterdam, Molewaterplein, NL-3015 DG, Rotterdam, The Netherlands

    Paul G. Hugenholtz M.D.

  4. Abteilung Innere Medizin III, Medizinische Universitätsklinik, Universität Heidelberg, Bergheimerstraße 58, D-6900, Heidelberg, Deutschland

    Wolfgang Kübler

  5. Center for Thrombosis and Vascular Research Campus Gasthuisberg, Katholieke Universiteit Leuven, Herestraat 49, B-3000, Leuven, Belgium

    Marc Verstraete M.D., Ph.D., F.R.C.P.

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Mathey, D.G., Schofer, J., Sheehan, F. (1987). Linksventrikuläre Funktion beim Patienten mit akutem Myokardinfarkt nach intrakoronarer oder systemischer Thrombolysebehandlung. In: de Bono, D.P., Brochier, M.L., Hugenholtz, P.G., Kübler, W., Verstraete, M. (eds) Thrombolytische Therapie des akuten Herzinfarkts. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72754-2_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-72754-2_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-17922-1

  • Online ISBN: 978-3-642-72754-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation