Related Experiment Video
Updated: Apr 3, 2026
Confirmation of Myocardial Ischemia and Reperfusion Injury in Mice Using Surface Pad Electrocardiography
Published on: November 24, 2016
ST-segment depression resolution predicts infarct size and reperfusion injury in ST-elevation myocardial infarction
Sebastian J Reinstadler1, Anett Baum2, Karl-Philipp Rommel3
1Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center Lübeck, University of Lübeck, Lübeck, Germany Cardiology and Angiology, University Clinic of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria.
Insights
In ST-elevation myocardial infarction (STEMI) patients, incomplete resolution of ST-segment depression (STD-R) after PCI indicates greater heart damage. This finding independently predicts major adverse cardiac events within 12 months.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Interventional Cardiology
Background:
- ST-elevation myocardial infarction (STEMI) often presents with reciprocal ST-segment depression.
- The prognostic significance of ST-segment depression resolution (STD-R) in STEMI is not fully understood.
- Evaluating STD-R may offer insights into myocardial injury and patient outcomes.
Purpose of the Study:
- To assess the association between STD-R and myocardial injury markers in STEMI patients.
- To determine the prognostic value of STD-R in acute reperfused STEMI.
- To investigate the relationship between STD-R and cardiac damage using cardiac magnetic resonance (CMR).
Main Methods:
- 611 STEMI patients were included in a multicenter CMR study.
- STD-R was categorized as worsened, incomplete, or complete 90 minutes post-primary percutaneous coronary intervention (PCI).
- Major adverse cardiac events (MACE) were tracked for 12 months.
Main Results:
- Worsened or incomplete STD-R correlated with larger area at risk, infarct size, and microvascular obstruction, alongside lower LVEF.
- Patients with incomplete or worsened STD-R had significantly higher MACE rates.
- Categorized STD-R independently predicted MACE at 12 months in multivariate analysis.
Conclusions:
- Incomplete STD-R after PCI in STEMI signifies more substantial myocardial and microvascular damage.
- STD-R provides independent prognostic information regarding MACE over a 12-month follow-up.
- CMR assessment combined with STD-R offers valuable prognostic insights in STEMI management.
Objective:
ST-elevation myocardial infarction (STEMI) is frequently associated with reciprocal ST-segment depression in contralateral ECG leads. However, the relationship of the resolution of ST-segment depression (STD-R) with myocardial damage is unknown and the potential prognostic value incompletely understood. We sought to evaluate the association between STD-R and markers of myocardial injury as well as to determine the prognostic impact of STD-R in patients with acute reperfused STEMI.
Methods:
We enrolled 611 patients with STEMI in this multicentre cardiac magnetic resonance (CMR) study. STD-R, defined as either worsened (<0%), incomplete (0-50%) or complete (≥50%), was determined 90 min after primary percutaneous coronary intervention (PCI). Patients underwent CMR in median 3 (2-4) days after infarction. Major adverse cardiac events (MACE) were defined as a composite of death, reinfarction and new congestive heart failure within 12 months after enrollment.
Results:
Patients with worsened or incomplete STD-R (n=148 (24.2%)) had a significantly larger area at risk (42 (31-50) vs 37 (29-52) vs 34 (24-46) %LV, p=0.001), larger infarct size (20 (13-30) vs 17(10-26) vs 16 (8-24) %LV, p=0.003), larger extent of microvascular obstruction (0.6(0-3.4) vs 0.4 (0-2.4) vs 0.0 (0-1.4) %LV, p=0.003), and a lower LVEF (46 (39-54) vs 48 (40-56) vs 52 (45-58) %, p<0.001). MACE rate (n=37 (6%)) was significantly higher in patients with worsened (n=10 (19%)) or incomplete STD-R (n=7 (7%)) than in patients with complete STD-R (n=20 (4%), p<0.001). In multivariate Cox regression analysis, categorised STD-R emerged as an independent predictor of MACE at 12 months after adjusting for clinical variables (p=0.007).
Conclusions:
Patients with acute STEMI and worsened or incomplete STD-R after PCI show a more pronounced myocardial as well as microvascular damage as detected by CMR with subsequent independent prognostic information on MACE over a 12-month follow-up period.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
11:17A Microscopic 2,3,5-Triphenyltetrazolium Chloride Assay for Accurate and Reliable Analysis of Myocardial Injury
Published on: November 28, 2025
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations