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      Prompt Improvement of Left Ventricular Function and Preservation of Topography with Combined Reperfusion and Intravenous Nitroglycerin in Acute Myocardial Infarction

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          Abstract

          Reperfusion alone during acute myocardial infarction (AMI) preserves left ventricular (LV) topography but causes ‘stunning’, with delayed or no recovery of function. To determine whether adjunctive intravenous nitroglycerin (NTG) accelerates functional recovery, we prospectively measured function and topography by repeated two-dimensional echocardiography between 1 day and 6 months in 5 groups of patients (n = 73) with a first AMI: placebo (group 1), NTG alone (group 2), NTG combined with successful reperfusion after 4 h (group 3) or failed reperfusion (group 4), and successful reperfusion alone (group 5). Asynergy decreased promptly (p < 0.001) and ejection fraction improved (p < 0.001) between day 1 and 6 months in groups 2 and 3 compared to baseline and groups 1, 4 and 5. Infarct expansion and thinning found in group 1 were prevented in groups 2, 3, 4 and 5. Diastolic volume increased in the anterior subgroup 1 but not 2, 3, 4 and 5. This is the first demonstration that reperfusion combined with adjunctive NTG produces earlier, greater and persistent recovery of LV function in addition to attenuation of remodeling in patients after AMI.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1997
          1997
          19 November 2008
          : 88
          : 2
          : 170-179
          Affiliations
          Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada
          Article
          177326 Cardiology 1997;88:170–179
          10.1159/000177326
          9096919
          © 1997 S. Karger AG, Basel

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          Page count
          Pages: 10
          Categories
          Coronary Care

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