Impact of the magnitude of the initial ST-segment elevation on left ventricular function in patients with anterior acute myocardial infarction.
BACKGROUND
In the percutaneous coronary intervention (PCI) era, the impact of initial ST-segment elevation magnitude on left ventricular (LV) function in patients with acute myocardial infarction (AMI) remains unclear.


RESULTS
In the present study, 239 patients with total occlusion and 81 patients with spontaneous reperfusion within 12 h of their first anterior AMI were evaluated. The sum of ST-segment elevation (SigmaST) was measured in leads I, aV(L) and V(1-6) shortly before angiography. Predischarge LV ejection fraction (LVEF) was obtained at 15+/-5 days. In total occlusion, the predischarge LVEF was significantly lower in patients with SigmaST >/=10 mm than in those with SigmaST <10 mm (51+/-14% vs 57+/-14%, p<0.01). However, in spontaneous reperfusion, there was no significant difference between patients with ST >/=10 mm and those with SigmaST <10 mm (61+/-13 vs 62+/-14 %, p=NS). Predischarge LVEF significantly correlated with SigmaST in total occlusion (r=-0.25, p<0.01), but not in spontaneous reperfusion (r=0.03, p=NS).


CONCLUSIONS
The results suggest that initial SigmaST is an important predictor of LV function in patients with total occlusion, but not in those with spontaneous reperfusion.
Department of Cardiology, Hiroshima City Hospital, Japan. skurisu@nifty.com
Satoshi
S
Kurisu
Ichiro
I
Inoue
Takuji
T
Kawagoe
Masaharu
M
Ishihara
Yuji
Y
Shimatani
Naoya
N
Mitsuba
Takaki
T
Hata
Yasuharu
Y
Nakama
Tomohiko
T
Kisaka
Yasufumi
Y
Kijima
D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left