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Angiology
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Determinants of Left Ventricular Function Two Weeks and One Year After an Acute Myocardial Infarction

Tomasz Brzostek, M.D.

Institute of Cardiology, Krakow, Poland

Frans Van de Werf, M.D.

Departments of Cardiology,

Ilse Scheys, M.S.

Medical Statistics,

Luc Mortelmans, M.D.

Nuclear Medicine of K. U. Leuven, Belgium

André Aubert, Ph.D.

Departments of Cardiology,

Jacek S. Dubiel, M.D.

Institute of Cardiology, Krakow, Poland

Hilaire De Geest, M.D.

Departments of Cardiology,

This study examines possible covariates of left ventricular function two weeks and sixteen months after an acute infarction. It was performed in a group of 312 patients randomized double blindly to recombinant tissue plasminogen activator (rt-PA) (n=156) or placebo treatment and followed thereafter for at least one year. Two weeks after the infarction, enzymatic infarct size, infarct-related vessel, and number of diseased coronary arteries were significant determinants of the infarct-related regional wall motion (centerline method) (R2=0.25 to 0.60, P=0.0001). Enzymatic infarct size, regional wall motion of both infarct-related and remote areas, reinfarction, and treatment allocation were significant independent correlates of ejection fraction (R2=0.76), end-diastolic volume (R2 =0.20), and end-systolic volume (R2=0.69, P < 0.0001).

Infarct-related coronary artery and predischarge end-systolic volume were significant independent covariates of ejection fraction at rest (R2=0.47) after sixteen months. Age, enzymatic infarct size, and predischarge end-diastolic volume were independent determinants of the maximal (R2=0.49, P < 0.0001) and peak exercise ejection fraction (R2=0.49, P < 0.0001).

Angiology, Vol. 46, No. 1, 27-36 (1995)
DOI: 10.1177/000331979504600104
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