The authors quantified the changes of left ventricular kinetics during hospitalization after a first transmural myocardial infarction treated by direct percutaneous coronary angioplasty. For accurate quantification a group as close as possible to experimental conditions was selected. 64 patients (43 men), mean age 67.3 years (44-86) were investigated. The echocardiographic examination was made within 24 hours after admission and on discharge (9.8 days). A 16-segment of the left ventricle was used, the kinetics were evaluated by 4-grade score. The ejection fraction was calculated by Simpson's method from 4 cycles, the wall motion score index was calculated by the standard procedure. During the follow up period significant improvement of left ventricular kinetics occurred. The ejection fraction improved from the original 46 +/- 11% (median 41.5) to 51 +/- 11% (median 50.0) (p < 0.005), the wall motion score index from 1.6 +/- 0.3 (median 1.65) improved to 1.5 +/- 0.3 (median 1.60) (p < 0.005). Improvement of the investigated parameters correlated with the clinical course, 87% of the patients being free of any complications.
Conclusion: Successful direct angioplasty leads in patients with a first myocardial infarction to improvement of the ejection fraction and wall motion score index already during the first 10 days.