[Anterior ST segment depression in acute inferior myocardial infarct: significance of its reproducibility during early ergometric test].

The significance of anterior ST segment depression (V1-V4) at the time of acute inferior myocardial infarction and exercise-induced anterior ST segment depression were studied in 30 patients. All patients carried out: two-dimensional echocardiography in the acute phase of myocardial infarction (Echo 1) and at predischarge (Echo 2); symptom-limited exercise test; coronary arteriography. According to ST segment changes, patients were divided into Group A (n = 15) with exercise-induced anterior ST segment depression and Group B (n = 15) with no ST segment depression during exercise. Group A showed a lower work physical capacity than Group B (6.8 +/- 3 METS and 9 +/- 2 METS, respectively). The wall motion index in Group A was 0.26 +/- 0.14 in the Echo 1 and 0.22 +/- 0.18 in the Echo 2 showing an improvement in wall motion abnormality; in Group B the same index was 0.35 +/- 0.19 in the Echo 1 and 0.34 +/- 0.18 in the Echo 2. Group A patients had a higher prevalence of multivessel disease compared with Group B patients and the right coronary artery was always involved. In conclusion, in inferior myocardial infarction the anterior ST segment depression, both in the acute phase and during the predischarge exercise test, reflects more extensive coronary disease and jeopardized myocardium.