EFFECTS OF TISSUE PLASMINOGEN ACTIVATOR THERAPY ON RIGHT VENTRICULAR INFARCTION

组织纤溶酶原激活剂治疗对右心室梗死的影响

• 批准号: 3843429
• 负责人: W C ROBERTS
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3843429
• 关键词: coronary occlusion /thrombosis; creatine kinase; heart ventricle; histopathology; human therapy evaluation; human tissue; myocardial infarction; necrosis; plasminogen activator; postmortem; reperfusion

In order to assess the effects of reperfusion therapy on right ventricular myocardial infarction, we studied at necropsy the hearts from 51 patients who died after receiving intravenous recombinant tissue plasminogen activator for left ventricular myocardial infarction as part of the TIMI trial. Right ventricular infarction occurred in none of 29 patients with anterior wall left ventricular infarction, and in 8 of 22 patients (36%) with inferior wall left ventricular infarction. Of the 22 patients with inferior wall infarction, the 8 patients with right ventricular infarction were compared to the 14 patients without right ventricular infarction. Patients with right ventricular infarction had a longer mean interval from tissue plasminogen activator infusion to peak creatine phosphokinase level (19 hr vs 11 hr, p less than 0.03), a lower incidence of hemorrhagic necrosis (2 of 8 [25%] vs 10 of 14 [71%], p less than 0.04), and higher incidence of luminal thrombus in the infarct-related coronary artery (6 of 8 [75%] vs 3 of 14 [21%], p=0.054). Each of these findings is associated with the absence of coronary reperfusion. Thus, it appears that successful reperfusion following acute left ventricular myocardial infarction is associated with a decreased incidence of concomitant right ventricular myocardial infarction.

为了评估再灌注治疗对右心室的影响， 心室心肌梗死，我们在尸检时研究了 51名患者在接受静脉注射重组组织后死亡， 纤溶酶原激活剂治疗左室心肌梗死 TIMI试验的结果 29例中无1例发生右室梗死 左室前壁梗死22例， 左室下壁梗死36例（36%）。 的 22例下壁梗死，8例右下壁梗死， 将心室梗死与14名没有右心室的患者进行比较 心室梗塞。 右心室梗死患者 从组织纤溶酶原激活剂输注到 肌酸磷酸激酶峰值水平（19小时vs 11小时，p <0.03），a 出血性坏死的发生率较低（2/8 [25%] vs 10/14 [71%]， p <0.04），且在对照组中管腔血栓的发生率较高。 梗死相关冠状动脉（6/8 [75%] vs 3/14 [21%]， p=0.054）。 这些发现中的每一个都与缺乏 冠脉再灌注 因此，似乎成功的再灌注 急性左心室心肌梗死后 伴随右心室心肌梗死的发生率降低 梗塞