TY - JOUR
T1 - Patency of infarct-related artery
T2 - Effect of restoration of anterograde flow on vagal reflexes
AU - Mortara, Andrea
AU - Specchia, Giuseppe
AU - La Rovere, Maria Teresa
AU - Bigger, J. Thomas
AU - Marcus, Frank I.
AU - Camm, John A.
AU - Hohnloser, Stefan H.
AU - Nohara, Ryuji
AU - Schwartz, Peter J.
PY - 1996/3/15
Y1 - 1996/3/15
N2 - Background: In post-myocardial infarction (MI) patients, the restoration of anterograde flow in the infarct-related artery (IRA) significantly improves survival. Limitation of infarct size and increased electrical stability of the myocardium are likely operating mechanisms for this beneficial effect. We tested the hypothesis that patency of the IRA may enhance vagal reflexes, a factor known to affect electrical stability of the infarcted myocardium. Methods and Results: Analysis of angiographic data was performed in 359 of 1284 post-M1 patients enrolled in a multicenter prospective study within 8 weeks after the index MI. All the patients underwent baroreflex sensitivity (BRS) assessment by the phenylephrine method. The BRS of the entire population averaged 8.2±5.5 ms/mm Hg and was significantly related to age but not to ejection fraction (EF). One-two-, and three-vessel disease was present in 138, 96, and 99 patients, respectively, while no coronary stenosis was observed in 26. IRA patency was documented in 234 patients (65%), while in the remaining 125 (35%), the artery remained occluded. Patients with occluded IRAs had more extensive coronary disease (2 to 3 vessels, 71% versus 46%, P
AB - Background: In post-myocardial infarction (MI) patients, the restoration of anterograde flow in the infarct-related artery (IRA) significantly improves survival. Limitation of infarct size and increased electrical stability of the myocardium are likely operating mechanisms for this beneficial effect. We tested the hypothesis that patency of the IRA may enhance vagal reflexes, a factor known to affect electrical stability of the infarcted myocardium. Methods and Results: Analysis of angiographic data was performed in 359 of 1284 post-M1 patients enrolled in a multicenter prospective study within 8 weeks after the index MI. All the patients underwent baroreflex sensitivity (BRS) assessment by the phenylephrine method. The BRS of the entire population averaged 8.2±5.5 ms/mm Hg and was significantly related to age but not to ejection fraction (EF). One-two-, and three-vessel disease was present in 138, 96, and 99 patients, respectively, while no coronary stenosis was observed in 26. IRA patency was documented in 234 patients (65%), while in the remaining 125 (35%), the artery remained occluded. Patients with occluded IRAs had more extensive coronary disease (2 to 3 vessels, 71% versus 46%, P
KW - angiography
KW - myocardial infarction
KW - nervous system, autonomic
KW - reperfusion
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M3 - Article
C2 - 8653831
AN - SCOPUS:0029869309
VL - 93
SP - 1114
EP - 1122
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 6
ER -