Functional and structural correlates of persistent ST elevation after acute myocardial infarction successfully treated by percutaneous coronary intervention. Issue 11 (19th February 2007)

• Record Type: Journal Article
• Authors: Galiuto, Leonarda; Barchetta, Sabrina; Paladini, Serena; Lanza, Gaetano; Rebuzzi, Antonio G; Marzilli, Mario; Crea, Filippo
• Is Part Of: Heart. Volume 93:Issue 11(2007)
• Page Start: 1376
• Page End: 1380
• Publication Date: 2007-02-19
• Subjects: microvascular dysfunction -- microcirculation -- myocardial infarction; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2006.105320
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: In the thrombolytic era, persistence of ST-segment elevation was considered a marker of left ventricular (LV) aneurysm. ST-segment elevation may still be found persistently raised after successful primary percutaneous coronary intervention (PCI). Echocardiographic correlates of this finding, however, are still poorly known. Methods and results: 82 consecutive patients with first ST-segment elevation myocardial infarction and successful PCI were divided into patients with persistent ST-segment elevation at discharge (sum of ST >4 mm) (n = 33) and those without persistent ST-segment elevation (n = 49). Conventional and myocardial contrast echocardiography were performed at discharge and at 6 months. At discharge, LV aneurysm was more common in patients with persistent ST elevation (27% vs 8%, p<0.005). Similarly, the wall motion score index was higher (2.5 vs 2.0, p<0.005) and microvascular damage larger (2.3 vs 1.8, p<0.005) in patients with persistent ST-segment elevation. At 6 months' follow-up, LV volumes were similar in the two groups. Conclusions: After primary PCI, persistent ST-segment elevation is associated with LV aneurysm formation in 30% of cases, it is not associated with significantly larger LV dilatation but with larger microvascular damage and dysfunctioning risk area.