Impact of the Magnitude of the Initial ST-Segment Elevation on Left Ventricular Function in Patients With Anterior Acute Myocardial Infarction

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Background In the percutaneous coronary intervention (PCI) era, the impact of initial ST-segment elevation magnitude on left ventricular (LV) function in patients with acute myocardial infarction (AMI) remains unclear. Methods and Results In the present study, 239 patients with total occlusion and 81 patients with spontaneous reperfusion within 12 h of their first anterior AMI were evaluated. The sum of ST-segment elevation (ΣST) was measured in leads I, aV_L and V_<1-6> shortly before angiography. Predischarge LV ejection fraction (LVEF) was obtained at 15±5 days. In total occlusion, the predischarge LVEF was significantly lower in patients with ΣST ≥ 10mm than in those with ΣST < 10mm (51±14% vs 57±14%, p<0.01). However, in spontaneous reperfusion, there was no significant difference between patients with ΣST ≥ 10mm and those with ΣST < 10mm (61±13 vs 62±14 %, p=NS). Predischarge LVEF significantly correlated with ΣST in total occlusion (r=-0.25, p<0.01), but not in spontaneous reperfusion (r=0.03, p=NS). Conclusion The results suggest that initial ΣST is an important predictor of LV function in patients with total occlusion, but not in those with spontaneous reperfusion. (Circ J 2004; 68: 903-908)
社団法人日本循環器学会の論文
2004-09-20