title: Predicting recovery of myocardial function by electrocardiography after acute infarction.
abstract: BACKGROUND
  In acute ischemic left ventricular (LV) dysfunction, distinguishing viable myocardium is clinically important.
  
  
  METHODS
  Body surface potential mapping (Electrocardiography [ECG] with 123 leads), was recorded in 62 patients with acute coronary syndrome (ACS). ECG variables were computed from de- and repolarization phases. LV segmental wall motion was assessed by echocardiography acutely and after 1 year.
  
  
  RESULTS
  The number of dysfunctional segments (DFS) diminished during follow-up in 37 patients (recovery group) and remained the same or increased in 25 patients (nonrecovery group). Acutely, DFS was 5.7 ± 2.1 versus 4.4 ± 2.4 (P = 0.02), and peak CK-MBm 141 ± 157 versus 156 ± 167 μg/L (P = 0.78) in the recovery versus nonrecovery group. At follow-up, DFS was 1.9 ± 1.7 versus 6.5 ± 2.6 (P < 0.001). The best ECG variable to predict decrease in DFS depended on the region of acute LV dysfunction: The best variable in the left anterior descending region was the integral of the first QRS integral (area under the curve [AUC] 0.82, P = 0.002); in the right coronary artery region, this was the integral of the ST segment (AUC 0.98, P = 0.003); and in the left circumflex region, the area including the ST segment and the T wave (AUC 0.97, P = 0.006).
  
  
  CONCLUSIONS
  In ACS patients, computed ECG variables predict recovery of LV function from ischemic myocardial injury, even in the presence of comparable CK-MBm release and LV dysfunction.
authors.affiliation: Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. fredrik.holmqvist@duke.edu
authors.forename: Minna M
authors.initials: MM
authors.lastname: Kylmälä
authors.forename: Teijo
authors.initials: T
authors.lastname: Konttila
authors.forename: Paula
authors.initials: P
authors.lastname: Vesterinen
authors.forename: Mats
authors.initials: M
authors.lastname: Lindholm
authors.forename: Heikki
authors.initials: H
authors.lastname: Väänänen
authors.forename: Matti
authors.initials: M
authors.lastname: Stenroos
authors.forename: Markku S
authors.initials: MS
authors.lastname: Nieminen
authors.forename: Helena
authors.initials: H
authors.lastname: Hänninen
authors.forename: Lauri
authors.initials: L
authors.lastname: Toivonen
mesh_terms: D018780:Body Surface Potential Mapping; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D020127:Recovery of Function; D015912:Thrombolytic Therapy