Most of these patients have had a revascularized LAD either from acute PTCA or thrombolysis that did not save all the muscle. Yes, the best thing we've found so far is to get a gated MRI to see the subsegment motion. Of course we can also use a PET scan and other viability studies. I don't know what that percent is yet, but the registry will prove it. Ventricular Remodeling Following MI Myocardial infarction of the anterior wall leads to changes in ventricular shape.
Systolic dyskinesia develops in the absence of reperfusion.
After successful thrombolysis or angioplasty, a variable amount of myocardium is salvaged, and the nonfunctional segment may become akinetic. Dramatic improvement in regional left ventricular systolic function is not common after thrombolytic therapy. In each instance there is loss of contraction of the anterior wall and septum, and the remote muscle dilates as an adaptive mechanism to maintain stroke volume. Progressive remodeling, however, may become pathogenic through its effect on the remote non-infarcted myocardium. Dilation distorts the normal fiber angle, which adversely effects systolic torsion.