[ST segment re-evaluation immediately after successful recanalization in acute myocardial infarction: predictor for poor recovery of left ventricular regional wall motion].
The value of recanalization therapy in restoring risk area after acute coronary occlusion is well documented. However, some cases show poor recovery of left ventricular function regardless of early reperfusion. This study investigated the use of ST segment re-elevation immediately after recanalization in patients with acute myocardial infarction as a predictor of recovery of regional wall motion and risk area. ST segment change and regional wall motion were compared in 16 patients with [ST(+)] and 8 patients without ST segment re-elevation [ST(-)] after successful recanalization within 6 hours from onset. ST segment re-elevation was defined as 0.2 mV or more in at least two contiguous leads immediately after recanalization. Wall motion was measured from single-plane ventriculograms performed in the acute and chronic (3-4 weeks later) phases in the infarct regions by the centerline method. Hypokinesis was defined as more than -2SD/chord(c) below normal and expressed as SD/c for the severity of regional wall motion and chord number(CN) for risk area. Time from symptom onset to recanalization did not differ between the two groups [3.8 +/- 1.2 hours for ST(-), 3.9 +/- 0.9 hours for ST(+), not significant]. In the ST(-) group, regional wall motion improved from -2.92 +/- 0.33 to -1.45 +/- 0.81 SD/c (p = 0.0005) and risk area decreased from 29.8 +/- 16.6 to 9.5 +/- 15.7 CN (p = 0.005) in the acute and chronic phases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Shimamoto
K
K
Department of Cardiology, Heart Institute of Japan, Tokyo Women's Medical College.
Uchida
T
T
Kaneko
N
N
Hosoda
S
S
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D015425:Myocardial Reperfusion; D011379:Prognosis; D015912:Thrombolytic Therapy; D016277:Ventricular Function, Left