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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Myocardial abnormalities underlying persistent ST-segment elevation after anterior myocardial infarction

Massimo Napodano1, Giuseppe Tarantini, Angelo Ramondo

  • 1Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy. massimo.napodano@gmail.com

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|January 16, 2009
PubMed

Insights

Persistent ST-segment elevation after myocardial infarction is linked to microvascular damage. This contrast-enhanced MRI study found microvascular damage to be the strongest predictor of this ECG finding.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Pathophysiology

Background:

  • Persistent ST-segment elevation post-myocardial infarction (MI) is often linked to left ventricular aneurysm.
  • The underlying pathophysiological mechanisms require further elucidation.

Purpose of the Study:

  • To investigate myocardial structural and functional abnormalities associated with persistent ST-segment elevation after MI.
  • Utilize contrast-enhanced magnetic resonance imaging (CE-MRI) to assess these abnormalities.

Main Methods:

  • Forty patients with a first anterior MI treated with primary angioplasty underwent CE-MRI.
  • Persistent ST-segment elevation was defined as ≥2 mm elevation in ≥2 leads on predischarge ECG.
  • CE-MRI assessed infarct size, transmural necrosis, microvascular damage, and wall motion abnormalities.

Main Results:

  • Patients with persistent ST-segment elevation exhibited larger infarct size index and more frequent transmural necrosis.
  • Persistent microvascular damage was significantly more prevalent in patients with ST-segment elevation (P=0.003).
  • Multivariate analysis identified persistent microvascular damage as the sole independent predictor (OR 3.13, P=0.01).

Conclusions:

  • Persistent ST-segment elevation after anterior MI correlates with increased transmural necrosis and microvascular damage.
  • Persistent microvascular damage is the most significant determinant of persistent ST-segment elevation.
Abstract

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