Left Ventricular Function Following Thrombolytic Therapy for Myocardial Infarction

The introduction of thrombolytic therapy to treat eligible patients with acute infarction has markedly reduced deaths from left ventricular (LV) failure. Following reperfusion therapy for acute myocardial infarction (MI), LV function remains the single most significant prognostic factor. Three trials have shown that LV function and survival improved in concert, following randomization to receive thrombolytic therapy. The Global Utilization of Strategies to Open Occluded Coronary Arteries study (GUSTO-1) showed that end-systolic volume at 90 minutes (or 180 minutes) after starting thrombolytic therapy correlates with early thrombolysis in myocardial infarction (TIMI) flow grades as well as survival.