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Potential influence of pre-infarction angina on myocardial viability and residual ischemia

F De Felice1, E Gostoli, M Russo

  • 1Division of Cardiology, Civic Hospital of Chivasso, TO, Italy. f.defelice@eudoramail.com

Italian Heart Journal : Official Journal of the Italian Federation of Cardiology
|June 8, 2001
PubMed

Insights

Recent pre-infarction angina in first Q-wave myocardial infarction patients is linked to smaller infarct size. However, it does not appear to affect myocardial viability or residual ischemia detected by dobutamine echocardiography.

Area of Science:

  • Cardiology
  • Echocardiography
  • Myocardial Infarction

Background:

  • The impact of recent pre-infarction angina on myocardial viability and residual ischemia following myocardial infarction is not well understood.
  • This study investigates these effects in patients experiencing their first Q-wave myocardial infarction.

Purpose of the Study:

  • To evaluate the influence of recent pre-infarction angina on myocardial viability and residual ischemia.
  • To assess contractile function and ischemia using early dobutamine stress echocardiography in patients with first Q-wave myocardial infarction.

Main Methods:

  • Ninety patients with a first Q-wave myocardial infarction were divided into groups with and without recent pre-infarction angina (chest pain < 30 min within 7 days prior).
  • Infarct zone wall motion score index was assessed at rest and during low- and peak-dose dobutamine stress echocardiography.
  • Coronary angiography was performed on all subjects.

Main Results:

  • Patients without recent pre-infarction angina had significantly higher peak creatine kinase levels and more leads with pathological Q waves.
  • No significant differences were observed in infarct zone wall motion score index at rest or during dobutamine stress echocardiography between groups.
  • Prevalence of myocardial viability, homozonal, and heterozonal ischemia did not differ significantly between the groups.

Conclusions:

  • Recent pre-infarction angina is associated with a smaller infarct size in patients with first Q-wave myocardial infarction.
  • It does not appear to influence ventricular contractile improvement or residual ischemia as detected by early dobutamine echocardiography.
Abstract

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