Prediction of improvement in left ventricular function during a 1-year follow-up after acute myocardial infarction by the degree of acute resolution of electrocardiographic changes

J Electrocardiol. 2007 Sep-Oct;40(5):416-21. doi: 10.1016/j.jelectrocard.2007.05.007. Epub 2007 Jul 2.

Abstract

Background and purpose: Reperfusion therapy results in better left ventricle (LV) function in cases of successful myocardial reperfusion; however, insufficient reperfusion or reocclusion of the infarct-related artery is associated with LV dysfunction. This study was proposed to determine whether the rate of ECG stage dynamics, after mechanical, thrombolytic, or spontaneous recanalization, is a predictor of improvement in LV function.

Methods: Twenty-seven consecutive patients, observed for 1 year, were divided into group A (11, change rate of > or =2 ECG stages per 2 days), group B (13, no rapid change), and cases with reocclusion (3).

Results: Clinical and radiographic signs of heart failure tended to decrease in group A but tended to increase in other cases. Echocardiographic dyssynergic score decreased, and LV ejection fraction increased only in group A: 4.3 +/- 1.2 vs 2.7 +/- 1.5, P = .04, and 42.0 +/- 4.8 vs 46.0 +/- 8.3, P = .049, respectively; in group B, the values were 3.4 +/- 2.4 vs 3.4 +/- 2.2 and 44.0 +/- 6.9 vs 43.8 +/- 9.3, respectively.

Conclusions: Rapid ECG stage changes predict follow-up improvement in LV function.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Diagnosis, Computer-Assisted / methods*
  • Electrocardiography / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / therapy*
  • Myocardial Reperfusion / methods*
  • Outcome Assessment, Health Care / methods*
  • Prognosis
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Treatment Outcome