Late Reperfusion (6-24 Hours After Onset) Improves Left Ventricular Function in Patients With Acute Myocardial Infarction

Shoichi Miyamoto; Yoichi Goto; Masatoshi Fujita; Satoshi Daikoku; Noritoshi Nagaya; Satoshi Yasuda; Hitoshi Sumida; Isao Morii; Akira Itoh; Shunichi Miyazaki; Hiroshi Nonogi

doi:10.1253/jcj.65.389

Clinical Investigation

Late Reperfusion (6-24 Hours After Onset) Improves Left Ventricular Function in Patients With Acute Myocardial Infarction

Shoichi Miyamoto, Yoichi Goto, Masatoshi Fujita, Satoshi Daikoku, Noritoshi Nagaya, Satoshi Yasuda, Hitoshi Sumida, Isao Morii, Akira Itoh, Shunichi Miyazaki, Hiroshi Nonogi

Author information

Shoichi Miyamoto
Division of Cardiology, Takeda Hospital
Yoichi Goto
Division of Cardiology, National Cardiovascular Center
Masatoshi Fujita
College of Medical Technology, Kyoto University
Satoshi Daikoku
Division of Cardiology, National Cardiovascular Center
Noritoshi Nagaya
Division of Cardiology, National Cardiovascular Center
Satoshi Yasuda
Division of Cardiology, National Cardiovascular Center
Hitoshi Sumida
Division of Cardiology, National Cardiovascular Center
Isao Morii
Division of Cardiology, National Cardiovascular Center
Akira Itoh
Division of Cardiology, National Cardiovascular Center
Shunichi Miyazaki
Division of Cardiology, National Cardiovascular Center
Hiroshi Nonogi
Division of Cardiology, National Cardiovascular Center

Keywords: Acute myocardial infarction, Hibernating myocardium, Late reperfusion, Regional wall motion

JOURNAL FREE ACCESS

2001 Volume 65 Issue 5 Pages 389-394

DOI https://doi.org/10.1253/jcj.65.389

Details

Abstract

The TAMI-6 trial has demonstrated that coronary reperfusion >6 h after onset (ie, late reperfusion) in patients with acute myocardial infarction (AMI) does not improve left ventricular (LV) function during the chronic phase of infarction. However, the low patency rate (only 60%) of the infarct-related artery (IRA) during the chronic phase in the TAMI-6 trial raises a new hypothesis that late reperfusion with a higher patency rate may improve LV function during the chronic phase. Forty-four patients with AMI, who were admitted to hospital 6-24 h after the symptom onset and in whom emergency coronary angiography revealed a total occlusion of the IRA, were randomly assigned to either the late reperfusion group (n=22) or the non-reperfusion group (n=22). The initial success rate of reperfusion therapy in the late reperfusion group was 86% and the chronic patency rate of the IRA was 91%. The improvements in ejection fraction and chord shortening in the infarct region from the acute phase to the chronic phase were significantly greater in the late reperfusion group than in the non-reperfusion group. Late reperfusion with a high patency rate of the IRA significantly improves LV global and regional function in patients with AMI.(Jpn Circ J 2001; 65: 389 - 394)

Corresponding author

Register with J-STAGE for free!