The evaluation of the cardiac function and the effect of urokinase therapy in patients with AMI in ICU

The cardiac function and the effect of therapy in patients with acute myocardial infarction (AMI) were assessed in 61 patients by analysis of Tl-scintigraphy and Tc-HSA gated pool study in our ICU. Nineteen of them were treated with intravenous Urokinase (UK) within 6 hours from onset. The other 36 patients without UK treatment served as a control group. Significant correlation was recognized between Tl-defect ratio calculated by the circumferential profile curve and peak-CPK levels with a correlation coefficient of 0.578. Significant correlation (r=-0.674) was found between Tl-defect ratio and LVEF. Cardiac function, Tl-defect ratio and peak-CPK levels were compared among patients with antero-septal AMI, inferior AMI and posterior AMI. Significant reductions of LVEF (37.2+-11.7 %) were observed in antero-septal AMI, while RVEF (43.0+-10.0 %) showed significant decreases in inferior AMI. In addition, Tl-defect ratio (3.36+-1.97) and peak-CPK levels in antero-septal AMI were significant higher than those in iferior AMI and posterior AMI. The UK group showed a significant increase of LVEF as compared with the control group in patients with antero-septal AMI. In patients with inferior AMI, no significant differences were observed between UK and control group in LVEF, RVEF and Tl-defect ratio. We have demonstrated that a combination of Tl-scintigraphy and Tc-HSA gated pool study are useful techniques especially when performed in ICU, to evaluate the cardiac function and the effect of thrombolysis therapy and thus greatly contribute to the primary care of AMI cases. (author)