<b>Does Coronary Artery Stenting for Acute Myocardial Infarction Improve Left Ventricular Overloading at the Chronic Stage?</b>
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- Nakayama Toru
- Department of Internal Medicine, Kochi Red Cross Hospital
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- Nomura Masahiro
- Department of Digestive and Cardiovascular Medicine, School of Medicine, University of Tokushima
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- Fujinaga Hiroyuki
- Department of Internal Medicine, Kochi Red Cross Hospital
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- Ikefuji Hiroyuki
- Department of Internal Medicine, Kochi Red Cross Hospital
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- Kimura Masaru
- Department of Internal Medicine, Kochi Red Cross Hospital
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- Chikamori Kazumasa
- Department of Internal Medicine, Kochi Red Cross Hospital
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- Nakaya Yutaka
- Department of Digestive and Cardiovascular Medicine, Nutrition, School of Medicine, University of Tokushima
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- Ito Susumu
- Department of Digestive and Cardiovascular Medicine, School of Medicine, University of Tokushima
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説明
In the present study, we evaluated whether stenting is useful for cardiac overloading, using ANP, BNP, and 99mTc-tetrofosmin myocardial scintigraphy. It has been reported that coronary artery stenting is useful for cardiac functions for acute myocardial infarction (AMI). The subjects were 110 patients with AMI successfully treated by direct angioplasty. These patients were subgrouped into two groups: the S group (underwent stenting; 54 patients) and the P group (underwent POBA alone; 56 patients). Extent scores reflecting decreased myocardial blood flow were calculated at myocardial areas showing a radioactivity count of less than -2 × standard deviations compared to the database of normal subjects.The ratio of extent scores to defect scores (extent/defect ratio) was compared between the P and S groups. Both ANP and BNP levels in the S group were lower than in the P group at the chronic stage (1 and 3 months after reperfusion therapy). Moreover, the end-diastolic volume index from the left ventriculography 3 months after reperfusion therapy was significantly larger in the P than the S group. The extent/defect ratio was significantly lower in the P group (2.8 ± 0.2) than the S group (3.5 ± 0.3), suggestive of a microcirculation disorder. These results suggest that cardiac overloading and left ventricular remodeling are decreased more by stenting than by POBA alone, probably because stenting prevents decreased myocardial blood flow around the infarct myocardium.<br>
収録刊行物
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- Ｊａｐａｎｅｓｅ Ｈｅａｒｔ Ｊｏｕｒｎａｌ
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Ｊａｐａｎｅｓｅ Ｈｅａｒｔ Ｊｏｕｒｎａｌ 45 (2), 217-229, 2004
International Heart Journal刊行会