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European Heart Journal 2004 25(3):224-231; doi:10.1016/j.ehj.2003.10.029
Copyright © 2004 by the European Society of Cardiology.
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Clinical review

ST segment elevation at 72 hours in patients with a first anterior myocardial infarction best correlates with pre-discharge and 1-year regional contractility and ventricular dilatation

Josefa Cortadellasa,*, Jaume Figuerasa, Mario Missoricia, Enric Domingoa, Josep Rodésa, Joan Castellb and Jordi Soler Solera

a Unitat Coronària–Secció d'Hemodinàmica, Servei de Cardiologia, Hospital General Vall d'Hebron, Barcelona, Spain
b Servei de Medicina Nuclear, Hospital General Vall d'Hebron, Barcelona, Spain

* Correspondence to: Josefa Cortadellas, M.D., Unitat Coronària, Servei de Cardiologia, Hospital General Vall d'Hebron, P. Vall d'Hebron 119-129, 08035 Barcelona, Spain. Tel: +34 932 746 134; fax +34 932 746002
E-mail address: jcortade{at}cs.vhebron.es

Received 14 March 2003; revised 20 October 2003; accepted 23 October 2003

Abstract

Aims To analyse the relationship between the in-hospital course of ST segment elevation (STE) and negative T wave (NTW) with ejection fraction, regional contractility and left ventricular end-diastolic volume at pre-discharge and at 1 year in patients with a first anterior STE acute myocardial infarction (AMI).

Methods and results ECG changes were measured during hospitalization and at 1 year whereas ejection fraction, regional contractility score and end-diastolic volume index were measured by isotopic ventriculography at pre-discharge and at 1 year. At 72h but not earlier patients with {Sigma}STE >0.6mV (group A, n: 35) had a lower ejection fraction (P<0.001), a higher regional contractility score (P<0.001) and a larger end-diastolic volume index (P<0.001) at discharge than those with 0.6mV (group B, n: 26). Negative T wave did not provide additional information. At 1 year, group A continued to show a more impaired ejection fraction and regional contractility than group B and a larger end-diastolic volume.

Conclusion Although reportedly changes in STE within the first hours correlate with coronary reperfusion our findings indicate that additional assessment of STE as early as at 72h correlates with wall motion, ejection fraction and ventricular dilatation at discharge and at 1 year.

Key Words: Myocardial infarction • Ejection fraction • Ventricular dilatation • Regional contractility


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