EFFECT ON GLOBAL AND REGIONAL LEFT-VENTRICULAR FUNCTIONS BY PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IN THE CHRONIC STAGE AFTER MYOCARDIAL-INFARCTION

Data are reported on 145 consecutive patients with prior myocardial infarction who had successful percutaneous transluminal coronary angioplasty (PTCA) of the infarct-related artery (5 +/- 6 months after infarction), and left ventricular (LV) angiograms before PTCA and during follow-up (7 +/- 4 months). There was a significant long-term improvement in LV function, ejection fraction increased from 60 +/- 13% to 64 +/- 13% (p < 0.001), and regional wall motion abnormalities decreased by 40%. Multivariate discriminant analysis identified reduced LV function and a high degree of stenosis before PTCA as predictors for improvement in LV function (ejection fraction < 60%: ejection fraction from 48 +/- 9% to 57 +/- 14%, p < 0.001; and stenosis greater-than-or-equal-to 90%: ejection fraction from 59 +/- 15% to 66 +/- 14%, p = 0.003). Restenosis greater-than-or-equal-to 90% in patients with initial stenosis < 90% decreased ejection fraction from 59 +/- 16% to 51 +/- 14% (p < 0.05). Other factors tested (treatment of infarction by thrombolysis, time between infarction and PTCA, and severity of angina pectoris) had no effect on long-term changes in LV function. It is concluded that successful elective PTCA of a high-grade stenosis in an infarct-related artery may improve LV ejection fraction and regional wall motion abnormalities, especially in patients with impaired LV function.