Impact of the efficiency of myocardial reperfusion after thrombolytic and spontaneous recanalization of infarct related artery on myocardial recovery in future

Objective. To assess the efficiency of myocardial reperfusion after thrombolytic and spontaneous recanalization of infarct related artery (IRA) by the serial 12 lead ECG data and its impact on subsequent myocardial recovery. Material and methods. We examined 25 patients with a first Q wave myocardial infarction at hospital and after 1 and 3 years from discharge (13 treated with intravenous thrombolysis, 12 treated conservatively). Four patients treated using thrombolysis and 3 patients treated conservatively were excluded from the analysis due to reocclusion or another myocardial infarction and coronary bypass surgery. The efficiency of myocardial reperfusion was assessed by our original method, based on the intensity of changes in ECG stages. The myocardial recovery was analyzed by quantitative changes in clinical, radiographic, echocardiographic and ECG (the Selvester \u96 Wagner QRS score) data. Results. Clinical and radiographic signs of heart failure decreased in cases of sufficient myocardial reperfusion after thrombolytic and spontaneous recanalization, but increased \u96 in cases of insufficient myocardial reperfusion. Echocardiographic dyssynergic score decreased after 3 yers from discharge (79, 67 after 1 and 3 yrs/at discharge (%), respectively, p<0.00005) in cases of thrombolysis with sufficient myocardial reperfusion but the tendency for increasing (113, 183 after 1 and 3 yrs/at discharge (%), respectively, p=0.07) was shown in cases of insufficient myocardial reperfusion; although, the QRS score decreased in both subgroups of thrombolysis (89, 36 after 1 and 3 yrs/at discharge (%), respectively, p<0.01, \u96 with sufficient myocardial reperfusion; 73, 62 after 1 and 3 yrs/at discharge (%), respectively, p