Circulation, Vol 75, 299-306, Copyright © 1987 by American Heart Association
JS Hochman and H Choo
Very early reperfusion after coronary occlusion can reduce infarct size and
preserve left ventricular function. Whether later reperfusion is of benefit
is unclear. We studied the effect of very early reperfusion with myocardial
salvage and "late" reperfusion without myocardial salvage on infarct
expansion and aneurysm formation. Sixty-eight rats underwent left coronary
artery ligation and were randomized to 30 min reperfusion, 2 hr
reperfusion, or permanent coronary artery ligation. The animals were killed
and the hearts examined at 2 weeks. Thirty minute reperfusion reduced
infarct size, extent of transmurality, and infarct expansion. Two hour
reperfusion reduced neither infarct size nor transmurality but inhibited
infarct expansion. The results of this study in the rat preparation suggest
a beneficial effect of "late" reperfusion on infarct expansion independent
of myocardial salvage. If these results are confirmed in human beings, the
period after myocardial infarction during which a patient can be considered
for thrombolytic therapy or reperfusion by percutaneous transluminal
coronary angioplasty could be greatly prolonged.
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Limitation of myocardial infarct expansion by reperfusion independent of myocardial salvage
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