title: Re-elevation of T-wave from day 2 to day 4 after successful percutaneous coronary intervention predicts chronic cardiac systolic dysfunction in patients with first anterior acute myocardial infarction.
abstract: This study evaluates the clinical significance of re-elevation of T-wave in patients with ST segment elevation acute myocardial infarction (STEMI) undergoing successful percutaneous coronary intervention (PCI). Resolution of ST elevation within 24 h after reperfusion is associated with better outcome. However, little is known about the serial electrocardiography (ECG) changes and their significance. Seventy-five patients (52 men; 66 ± 1 years) with the first anterior STEMI in whom 12-lead ECG was recorded every day from day 0 to day 8 after PCI were studied. JT interval was quartered (points 1-5), and the deviations from isoelectric line at each point were analyzed in leads V2, V3, and V4. Serial ECG showed ST resolution and T-wave inversion within 2 days after PCI in all patients at the middle of JT interval (point 3), and subsequent re-elevation of T-wave on day 4 in 73 patients (97.3 %). The patients were divided into two groups: Group A (n = 37) with less JT deviation changes (<0.25 mV) from day 2 to day 4 at point 3; and Group B (n = 38) with greater JT deviation changes (≥0.25 mV). Group B had less retrograde collateral flow and longer JT interval in the acute phase, and lower left ventricular ejection fraction (LVEF), worse regional contractility, and higher plasma brain natriuretic peptide levels at 6 months after the onset than Group A (all P < 0.05). The JT deviation change was negatively correlated with and an independent predictor for LVEF in the chronic phase. Re-elevation ≥0.25 mV of T-wave at the middle of JT interval after successful PCI predicts chronic cardiac systolic dysfunction in patients with first anterior STEMI.
authors.affiliation: Department of Cardiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Fumie
authors.initials: F
authors.lastname: Nishizaki
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tomita
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Takumi
authors.initials: T
authors.lastname: Higuma
authors.forename: Naoki
authors.initials: N
authors.lastname: Abe
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.forename: Tomohide
authors.initials: T
authors.lastname: Endo
authors.forename: Shunta
authors.initials: S
authors.lastname: Tateyama
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ishida
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Osanai
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056988:Anterior Wall Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left