[Value of ST-segment elevation resolution after primary coronary angioplasty in predicting early and late left ventricular function in patients with anterior acute myocardial infarction].

UNLABELLED

The aim of our study was to define a predictive value of ST-segment resolution after coronary reperfusion for early and late left ventricular (LV) function. We also studied its relation to angiographic marker of myocardial reperfusion, myocardial blush grade (MBG).

MATERIALS AND METHODS

Study population consisted of 105 patients (75 men, 30 women, mean age 62+/-13 years) treated with primary PTCA for anterior myocardial infarction (AMI) within 12 hours from symptoms onset. ECG was performed before - and 30 min. after PTCA. We evaluated angiographic markers of recanalization (TIMI, corrected TIMI frame count) and myocardial reperfusion - MBG. Echocardiography was performed 3 days and 6 months after AMI. Patients were divided into 2 groups regarding reduction -50% in ST segment elevation after recanalization (rST): group I (n=37) with rST, and group 2 (n=68) without rST RESULTS: In group I we noticed higher CPK level (2890,2+/-2404,2 U/I vs. 3980,9+/-2812,2 U/I, p<0,01). MB grade 3 was significantly more often found in group 1 at 29 pts (78,4%) than in group 2 at 18 pts (23,5%), p<0,0001. MG grade 0 or 1 were more often in group 2 (57,3% vs. 2,7%, p<0,01). Ejection fraction (EF) was higher in group 1 after 3 days (48,9+/-9,5% vs. 44,2+/-14,3%, p<0,01), as well as after 6 months (56,4+/-14,4% vs. 49,5+/-14,3%, p=0,001). After 6 months end-diastolic volume (EDV) was higher in group 2 (128,1+/-46,1 ml vs. 110,2+/-49,7 ml, p<0,008).

CONCLUSIONS

ST-resolution after successful PTCA is a simple and effective marker of myocardial reperfusion after recanalization which correlates with angiographic markers of tissue reperfusion. Early ST-segment resolution is connected with better early and late LV function. Patients without early ST-segment elevation resolution have a higher risk of LV remodelling.