Biplane ventriculography was performed during the acute and chronic stage (3 weeks) of myocardial infarction in 54 patients. Early recanalisation was attempted by intravenous streptokinase in 33, by intracoronary streptokinase in 15 and by catheter manipulation in 6 patients. In patients with successful recanalisation (n = 37) biplane LV ejection fraction (EFbi) increased slightly from 53 +/- 10 to 56 +/- 9% on the average, with late recanalisation or permanent occlusion EFbi decreased significantly from 47 +/- 11 to 39 +/- 8% (p less than 0.001). Correspondingly the akinetic segment length (AKS) and the number of akinetic radians (Sak) (semiautomated system) decreased with early recanalisation and increased with permanent occlusion. Comparing global and regional LV function, EF and Sak correlated closely (r = 0.81) while EF and AKS revealed only a loose correlation (r = 0.59). Biplane and RAO single plane EF correlated with an r-value of 0.88, Sy,x however was 9.9%. There was a considerable scatter in the relation between the parameters of regional wall motion, AKS and Sak (r = 0.80; Sy,x = 10.6).
CONCLUSIONS: On the average there is a slight improvement in LV function after successful early reperfusion, which seems to be independent of the method of recanalisation. Changes of regional akinesis after reperfusion cannot be assessed accurately by angiographic determination.
