Myocardial ischemia adjacent to infarction enhances the magnitude of exercise-induced ST-segment elevation one month after myocardial infarction.
The aims of this study were to compare exercise-induced ST-segment elevation with and without ischemia and to examine the relation between exercise-induced ST-segment elevation and the location of myocardial ischemia. Seventy-nine patients with first anterior myocardial infarction underwent thallium-201 exercise myocardial scintigraphy test one month after myocardial infarction. There were 37 patients showing no reversible defect (non ischemia group), 33 with reversible defect in the territory of the left descending coronary artery (homozonal ischemia group) and 9 with a reversible defect in the territory of the left circumflex or right coronary artery (remote ischemia group). There were no significant differences among the three groups with respect to infarct size, presence of dyskinesis and exercise endurance time. Patients with homozonal ischemia had the highest degree of ST-segment elevation (0.22 +/- 0.09 mV) followed by patients without ischemia (0.13 +/- 0.07 mV) and those with remote ischemia (0.09 +/- 0.08 mV, P <.01). In conclusion, Myocardial ischemia adjacent to infarction amplifies exercise-induced ST-segment elevation.
Yamamoto
Tadahiko
T
Department of Cardiology, Kinki University School of Medicine, Osakasayama, Japan. tdhk@mac.com
Miyazaki
Toshio
T
Hirano
Yutaka
Y
Ishikawa
Kinji
K
D002395:Catecholamines / Q000502:physiology; D004452:Echocardiography; D004562:Electrocardiography; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology*; D011877:Radionuclide Imaging; D013997:Time Factors; D016277:Ventricular Function, Left
D002395:Catecholamines