Objective Persistent ST-segment elevation after successful recanalization of infarct-related coronary artery (IRA) has been shown to corretale with impairment of microvascullar flow. We evaluated the relation between ...Objective Persistent ST-segment elevation after successful recanalization of infarct-related coronary artery (IRA) has been shown to corretale with impairment of microvascullar flow. We evaluated the relation between persistent ST-segment elevation shortly after primary stenting for acute myocardial in farction and left ventricular recovery. Methods From April 1998 to April 2001, we prospectively enrolled 26 patients with primary stenting for acute myocardial infarction. To evaluate the extent of microvascular injury, serial ST-segment analysis on a 18-lead ECG recording just before and at the end of the coronary intervention was performed. Persistent ST-segment elevation ( Group A, n=9 ) was defined as>50% of initial ST elevation and resolution ( Group B, n=17) defined as <50% of initial ST elevation. Echo cardiography was performed on day 1 and 3 month after primary stenting. Wall-motion recovery index was obtained by dividing the number of improved wall-motion segment (>grade 1 ) at follow-up by the number of abnormal wall-motion segment within the infarct zone at baseline. Results The mean patients age was 59 years and 73% were male. Baseline characteristics were similar between both groups. At a months, infarct zone wall-motion score index ( 2.16±0.51 VS. 2.69±0.32, p<0.05) was smaller in group B than in group A, whereas, wall motion recovery index ( 0.42±0.30 VS. 0.11±0.21, P<0.05) and ejection fraction (58±5% VS. 43±8%, p<0.05) were larger in group B than in group A. The extent of persistent ST-segment elevation ( %ST) shortly after successful recanalizaition of the IRA was significantly related to wall-motion recovery index at 3 months (r=-0.4, p<0.05). However, time to reperfusion was not related to wall-motion recovery index 3 months. Conclusions Persistent ST-segment elevation shortly after successful recanalization (>50% of the initial value), as a marker of impaired microvascular reperfusion, predicts poor left ventricular recovery 3 months after primary stenting for acute myocardial infarction.展开更多
文摘Objective Persistent ST-segment elevation after successful recanalization of infarct-related coronary artery (IRA) has been shown to corretale with impairment of microvascullar flow. We evaluated the relation between persistent ST-segment elevation shortly after primary stenting for acute myocardial in farction and left ventricular recovery. Methods From April 1998 to April 2001, we prospectively enrolled 26 patients with primary stenting for acute myocardial infarction. To evaluate the extent of microvascular injury, serial ST-segment analysis on a 18-lead ECG recording just before and at the end of the coronary intervention was performed. Persistent ST-segment elevation ( Group A, n=9 ) was defined as>50% of initial ST elevation and resolution ( Group B, n=17) defined as <50% of initial ST elevation. Echo cardiography was performed on day 1 and 3 month after primary stenting. Wall-motion recovery index was obtained by dividing the number of improved wall-motion segment (>grade 1 ) at follow-up by the number of abnormal wall-motion segment within the infarct zone at baseline. Results The mean patients age was 59 years and 73% were male. Baseline characteristics were similar between both groups. At a months, infarct zone wall-motion score index ( 2.16±0.51 VS. 2.69±0.32, p<0.05) was smaller in group B than in group A, whereas, wall motion recovery index ( 0.42±0.30 VS. 0.11±0.21, P<0.05) and ejection fraction (58±5% VS. 43±8%, p<0.05) were larger in group B than in group A. The extent of persistent ST-segment elevation ( %ST) shortly after successful recanalizaition of the IRA was significantly related to wall-motion recovery index at 3 months (r=-0.4, p<0.05). However, time to reperfusion was not related to wall-motion recovery index 3 months. Conclusions Persistent ST-segment elevation shortly after successful recanalization (>50% of the initial value), as a marker of impaired microvascular reperfusion, predicts poor left ventricular recovery 3 months after primary stenting for acute myocardial infarction.
