title: Electrocardiographic markers predict left ventricular wall motion improvement in patients with acute myocardial infarction receiving thrombolysis.
abstract: BACKGROUND
  In patients with ST-elevation myocardial infarction (STEMI) treated with fibrinolysis, prediction of early left ventricular wall motion changes is important for prognosis.
  
  
  METHODS
  In 106 patients with STEMI treated with thrombolysis, we analyzed the degrees of total and maximal ST-segment resolution at 3 hours and changes in sums of T-wave amplitudes in leads with ST elevation 3 and 48 hours after thrombolysis as the predictors of the echocardiographic left ventricular wall motion score index (WMSI) improvement.
  
  
  RESULTS
  Wall motion score index improvement was best predicted by total ST-segment resolution of more than 44% in anterior infarctions (sensitivity, 81%; specificity, 62%) and more than 59% in nonanterior infarctions (sensitivity, 100%; specificity, 42%) and by difference in sums of T-wave amplitudes between electrocardiograms at 48 hours and baseline less than -28 mm (sensitivity, 68%; specificity, 76%).
  
  
  CONCLUSIONS
  In STEMI, the total ST-segment resolution 3 hours and T-wave changes at 48 hours after thrombolysis are the reliable predictors of the left ventricular WMSI improvement.
authors.affiliation: Department of Cardiology, Medical Academy of Postgraduate Studies, Saint-Petersburg, Russia. l_berstein@yahoo.com
authors.forename: Leonid
authors.initials: L
authors.lastname: Berstein
authors.forename: Alexander
authors.initials: A
authors.lastname: Vishnevsky
authors.forename: Vladimir
authors.initials: V
authors.lastname: Novikov
authors.forename: Yuri
authors.initials: Y
authors.lastname: Grishkin
mesh_terms: D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*