Left ventricular function as an end-point of thrombolytic therapy

European Heart Journal
R M Norris, H D White

Abstract

For clinical prognosis, LV function is best described in terms of ejection fraction (EF) or end-systolic volume (ESV). Because deterioration of LV function is the most important adverse prognostic factor for patients after recovery from myocardial infarction, any agent which improves function should improve long-term survival. Clinical trials in which LV function has been measured have shown that early administration of all the presently available thrombolytic drugs improves LV function. There is, however, no evidence that one drug is better than another for preservation of LV function. Indeed in our double-blind comparison of streptokinase (SK) with tissue plasminogen activator (tPA) in which intervention was made at 2.5 +/- 0.6 h after onset, EF at 3 weeks after infarction was 58 +/- 12% for SK (n = 116) vs 58 +/- 12% for tPA (n = 124). The 95% confidence limit for the difference was 0 +/- 3%. Patency rates on the infarct-related artery at 3 weeks were similar in the two groups (75% SK, 76% tPA). Besides reflecting infarct size, LV function is also influenced by healing of the infarct, infarct expansion and LV remodelling. Two clinical trials have shown that captopril treatment started at 1-4 weeks after infarction and contin...Continue Reading

Citations

Jan 12, 2008·Proceedings of the National Academy of Sciences of the United States of America·Scott M Grundy
Oct 26, 2000·Journal of Manipulative and Physiological Therapeutics·J Y Maigne, F Guillon
Jul 24, 2004·Health Marketing Quarterly·Ik-Whan G Kwon, Henry Yu Xie

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiac Remodeling

Cardiac remodeling in response to a myocardial infarction is characterized by progressive ventricular dilatation, cardiac hypertrophy, fibrosis, and deterioration of cardiac performance. Discover the latest research on Cardiac Remodeling here.

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.