Improvement of left ventricular function after fibrinolysis using intravenous streptokinase

: Over a period of 13 months, 33 male patients, under the age of 72 years, admitted in the cardiology department following a myocardial infarction within 5 hours after painful onset, and treated with intravenous fibrinolytic agents, were included in this study. A coronary angiography with right anterior oblique ventriculography at 30 degrees was performed. Within the first 72 hours. The informations provided by this examination resulted in a coronary angioplasty performed in patients, a by-pass in 4 patients and medical treatment in 13 patients. After a mean delay of 8 months, a new control was performed using iodine ventriculography study of radial and segmental shortening fractions, Leighton's rotation). The results expressed, concern the sub-group of non-surgical patients: regardless of the site of the infarction, the percentage of akinesis (% AK) goes from 15.0 +/- 12.0 p. cent to 8.3 +/- 10.3 p. cent (p less than 0.01). The stroke volume (SV) is not significantly improved. In the group of inferior necroses, the global SV goes from 58.4 +/- 10.1 p. cent to 62.9 +/- 10.8 p. cent; p less than 0.05 and the % AK goes from 13.9 +/- 11.5 p. cent to 5.0 +/- 5.6 p. cent; p less than 0.001). Segmental kinetics in the inferior and infero-basal territories is significantly improved at eight months. In the anterior necrosis group, the study of the same parameters does not demonstrate any significant difference (too limited population). The imputability of the improvement of the parameters of the left ventricular function by arterial revascularization is clearly suggested by these results.