Beneficial effect of residual flow to the infarct region on left ventricular volume changes after acute myocardial infarction

Shen, Wei Feng; Cui, Lian Qun; Gong, L S; Lesbre, J P

doi:10.1016/s0002-8703(05)80274-1

Cited by 12 publications

(2 citation statements)

References 26 publications

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“…They suggested that a prominent right precordial R wave is an ECG hallmark of infarction in surrounding segments that have extended into the basal lateral segments [3], In this study, 38% of patients with LCX-related infarc tion had a left coronary dominance pattern, and 82% of patients with left coronary dominance pattern and an abnormal R wave in lead V i had total occlusion of proxi mal LCX without collaterals. These findings confirm the observations that the size of circulation and the location of occlusion for each major epicardial coronary artery are related to infarct size [3] and substantiate the importance of residual flow of the infarct region [17],…”

Section: Relation Of Ecg Patterns To Left Ventricular Functionsupporting

confidence: 87%

Isolated Left Circumflex Coronary Artery Occlusion as a Cause of Myocardial Infarction

Lesbre¹,

Shen²,

Tribouilloy³

et al. 1993

Am J Noninvas Cardiol

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The relation of electrocardiographic (ECG) patterns to clinical spectrum and angiographic features was assessed in 47 patients with a first myocardial infarction due to isolated left circumflex coronary artery (LCX) occlusion and compared to that in 51 patients with right coronary artery (RCA)-related infarction. The occurrence of inferior Q waves and an abnormal R wave in lead V(1) were more frequent in patients with LCX-related infarction (46 vs. 7% and 51 vs. 4%, respectively). Compared to patients with LCX-related infarction without an abnormal R wave in lead Vi and those with RCA occlusion, patients with LCX-related infarction and an abnormal R wave in lead V) associated with inferior and/or lateral Q waves had larger left ventricular enddiastolic and end-systolic volumes, a lower ejection fraction, a higher incidence of total occlusion of a dominant LCX without collaterals and more cardiac events during follow-up. The study suggests that (1) the presence of lateral Q waves and an abnormal R wave in lead V i after myocardial infarction may be a useful marker of LCX occlusion and (2) patients with LCX-related infarction may have a different status of left ventricular function depending on the size of circulation and the status of residual flow to the infarct region during LCX occlusion.

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Section: Relation Of Ecg Patterns To Left Ventricular Functionsupporting

confidence: 87%

Isolated Left Circumflex Coronary Artery Occlusion as a Cause of Myocardial Infarction

Lesbre¹,

Shen²,

Tribouilloy³

et al. 1993

Am J Noninvas Cardiol

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“…Patients were examined in the left lateral decubitus position. LV volumes were measured from an apical four-chamber view using the area-length method described previously [7] and ejection fraction was calculated.…”

Section: Doppler Echocardiographie Examinationmentioning

confidence: 99%

Effects of Acute Angiotensin-Converting Enzyme Inhibition on Left Ventricular Systolic and Diastolic Functional Response to Isometric Exercise in Idiopathic Dilated Cardiomyopathy

Shen¹,

Huang²,

Tribouilloy³

et al. 1994

Am J Noninvas Cardiol

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We evaluated the acute effects of angiotensin-converting enzyme (ACE) inhibition on hemodynamic and left ventricular (LV) functional response to isometric exercise in 19 patients with idiopathic dilated cardiomyopathy and symptoms of congestive heart failure. LV systolic performance and diastolic filling velocity profiles were assessed by two-dimensional echocardiography and pulsed wave Doppler at rest and during handgrip exercise before and 90 min after administration of captopril (mean dose 25 ± 12 mg; range 12.5- 50 mg). Although heart rate and blood pressure increased similarly during handgrip exercise before and after captopril treatment, both were lower with handgrip exercise during captopril treatment. LV end-diastolic (210 ± 32 vs. 225 ± 39 ml; p < 0.05) and end-systolic volumes (149 ± 29 vs. 177 ± 37 ml; p < 0.01) were smaller and ejection fraction (0.29 ± 0.05 vs. 0.22 ± 0.05) was higher during captopril handgrip exercise. After captopril treatment, peak early filling velocity (72 ± 33 vs. 82 ± 34 cm/s; p < 0.01) and early to late filling velocity ratio (1.47 ± 1.24 vs. 2.02 ± 2.07; p < 0.05) were lower, and deceleration time was longer (151 ± 84 vs. 125 ± 46 ms; p < 0.05) during handgrip exercise than those during control studies at identical workloads. The study indicates that acute ACE inhibition with captopril reduces preload and afterload and ameliorates handgrip exercise-induced worsening of LV systolic dysfunction and diastolic filling abnormalities in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy.

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Relationship between electrocardiographic patterns and angiographic features in isolated left circumflex coronary artery disease

Shen

Tribouilloy

Lesbre

1991

Clinical Cardiology

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Summary:The relation of electrocardiographic (ECG) patterns to clinical and angiographic features was assessed in 89 patients with isolated left circumflex coronary artery (LCx) disease (46 with and 43 without myocardial infarction). ECG abnormalities were present in 75 patients; there were isolated Q waves in 20, an abnormal R wave in lead V, with or without inferior and/or lateral Q waves in 21, and isolated ST-T wave changes in 34 cases. Inferior abnormalities on the electrocardiogram were similar in patients with proximal or distal stenoses of the LCx, but an abnormal R wave in lead V, correlated with proximal LCx stenosis (p< 0.01). Lateral abnormalities were more common in stenoses of the obtuse marginal branch and proximal LCx than in distal stenosis (all ~~0 . 0 1 ) .Compared with patients without myocardial infarction with or without ST-T-wave changes and those with infarction without an abnormal R wave in lead V,, patients with LCx-related infarction and an abnormal R wave in lead V, associated with inferior and/or lateral Q waves had larger left ventricular end-diastolic and end-systolic volumes, lower ejection fraction, higher incidence of total occlusion of proximal LCx without collateral vessels, and more cardiac events during follow-up. This study suggests that an abnormal R wave in lead V , associated with lateral abnormalities on the standard electrocardiogram may be clinically useful in predicting proximal LCx stenosis and identifying a subset of postinfarction patients with left ventricular dysfunction due to a large infarct size.

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Beneficial effect of residual flow to the infarct region on left ventricular volume changes after acute myocardial infarction

Cited by 12 publications

References 26 publications

Isolated Left Circumflex Coronary Artery Occlusion as a Cause of Myocardial Infarction

Isolated Left Circumflex Coronary Artery Occlusion as a Cause of Myocardial Infarction

Effects of Acute Angiotensin-Converting Enzyme Inhibition on Left Ventricular Systolic and Diastolic Functional Response to Isometric Exercise in Idiopathic Dilated Cardiomyopathy

Relationship between electrocardiographic patterns and angiographic features in isolated left circumflex coronary artery disease

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