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Relationship between myocardial viability and the predischarge electrocardiographic pattern in patients with first

Ramazan Atak1, Hasan Turhan, Kubilay Senen

  • 1Turkiye Yuksek Ihtisas Hospital, Department of Cardiology, Ankara, Turkey. hratak@yahoo.com

International Journal of Cardiology
|October 16, 2003
PubMed

Insights

Isoelectric ST segments and negative T waves on ECG strongly suggest viable myocardium after acute myocardial infarction (AMI). However, their absence does not rule out myocardial viability, requiring further assessment.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrocardiography

Background:

  • Assessing residual myocardial viability post-acute myocardial infarction (AMI) is crucial for patient prognosis and treatment.
  • Electrocardiographic (ECG) patterns of ST segment and T wave abnormalities are commonly observed after AMI.

Purpose of the Study:

  • To determine the correlation between myocardial viability, assessed by low-dose dobutamine stress echocardiography (LDDSE), and specific ECG patterns.
  • To evaluate the predictive value of ST segment and T wave morphology for myocardial viability in patients with anterior AMI.

Main Methods:

  • Sixty-nine patients with first-episode transmural AMI underwent LDDSE at the end of the first week.
  • Patients were categorized into four groups based on ST segment (elevation or isoelectric) and T wave (positive or negative) morphology.
  • Two-dimensional echocardiography was performed at rest and during LDDSE.

Main Results:

  • Myocardial viability was significantly more frequent in patients with isoelectric ST segments (92%) compared to those with elevated ST segments (47%).
  • Negative T waves were associated with higher rates of myocardial viability (71%) than positive T waves (46%).
  • Isoelectric ST segments showed high specificity (92%) but moderate sensitivity (51%) for viable myocardium.

Conclusions:

  • Isoelectric ST segments and negative T waves on ECG are strong indicators of myocardial viability after AMI.
  • The absence of these specific ECG patterns does not exclude the presence of viable myocardium, necessitating further investigation.
Abstract

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