Electrocardiographic markers predict left ventricular wall motion improvement in patients with acute myocardial

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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

Leonid Berstein1, Alexander Vishnevsky, Vladimir Novikov

  • 1Department of Cardiology, Medical Academy of Postgraduate Studies, Saint-Petersburg, Russia. l_berstein@yahoo.com

Journal of Electrocardiology
|December 18, 2010
PubMed

Insights

Early prediction of left ventricular wall motion changes in ST-elevation myocardial infarction (STEMI) is crucial. Total ST-segment resolution and T-wave changes after thrombolysis reliably predict improvement in STEMI patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrocardiography

Background:

  • Prognosis in ST-elevation myocardial infarction (STEMI) depends on early left ventricular wall motion assessment.
  • Fibrinolysis is a key treatment for STEMI, necessitating predictive markers for patient outcomes.

Purpose of the Study:

  • To identify reliable predictors of left ventricular wall motion score index (WMSI) improvement in STEMI patients treated with thrombolysis.
  • To evaluate the utility of ST-segment resolution and T-wave amplitude changes as early prognostic indicators.

Main Methods:

  • Analysis of 106 STEMI patients undergoing thrombolysis.
  • Assessment of total and maximal ST-segment resolution at 3 hours post-thrombolysis.
  • Measurement of T-wave amplitude changes at 48 hours and baseline.

Main Results:

  • Total ST-segment resolution >44% (anterior) and >59% (nonanterior) predicted WMSI improvement.
  • T-wave amplitude difference < -28 mm at 48 hours also predicted WMSI improvement.
  • Specific sensitivities and specificities were reported for these predictive markers.

Conclusions:

  • Total ST-segment resolution at 3 hours is a reliable predictor of WMSI improvement in STEMI.
  • T-wave changes at 48 hours post-thrombolysis also reliably predict left ventricular recovery in STEMI patients.
Abstract

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