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Correlation of cumulative ST elevation with left ventricular ejection fraction and 30-day outcome in patients with ST

V Kiron1, P V George1

  • 1Department of Cardiology, Christian Medical College, Vellore, Tamil Nadu, India.

Journal of Postgraduate Medicine
|June 7, 2019
PubMed

Insights

ST elevation (STE) on ECG correlates with left ventricular ejection fraction (LVEF) in ST-elevation myocardial infarction (STEMI) patients. This finding aids in predicting prognosis using ECG measurements.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Clinical Diagnostics

Background:

  • The electrocardiogram (ECG) is crucial for diagnosing ST-elevation myocardial infarction (STEMI) before treatment.
  • Left ventricular ejection fraction (LVEF) is a key prognostic indicator in STEMI.
  • Assessing LVEF non-invasively via ECG can improve patient management.

Purpose of the Study:

  • To determine the correlation between ST elevation (STE) on ECG and LVEF in STEMI patients.
  • To explore the utility of STE as a prognostic marker.
  • To develop a method for estimating LVEF using ECG findings.

Main Methods:

  • Prospective cohort study involving 230 STEMI patients.
  • Baseline ECGs were used to measure the sum of ST elevation (STE).
  • LVEF was measured by echocardiography 90 minutes post-revascularization; ST resolution (STR%) was also calculated.

Main Results:

  • A significant inverse correlation (r=-0.64) was found between STE and LVEF.
  • ST resolution percentage (STR%) showed a positive correlation (r=0.59) with LVEF.
  • A formula was derived to estimate LVEF from STE, and STE ≥15 mm predicted LVEF <35% with 70% sensitivity and specificity.

Conclusions:

  • ST elevation (STE) and ST resolution (STR%) are valuable surrogate markers for STEMI prognosis.
  • These ECG parameters can aid in patient risk stratification regardless of STEMI type.
  • The study provides a practical method for estimating LVEF from ECG in STEMI.
Abstract

Keywords:
ST elevation myocardial infarctionST resolution percentagesum ST elevation

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