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Repolarization parameters in patients with acute ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention with respect to predischarge ST-T pattern: A preliminary study
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Abstract
Background: Negative T wave and lack of ST segment elevation in predischarge ECG in ST-segment elevation myocardial infraction (STEMI) patients are given as markers of good prognosis. Repolarization duration, especially its late part (TpeakTend - TpTe), likewise ST-T patterns, is related to local post-myocardial infarction myocardial attributes. We analyzed the differences in QT parameters in STEMI patients with negative or not-negative T wave pattern in predischarge ECG.
Methods: The data from 83 STEMI patients (LVEF > 45%, first MI, one-vessel disease) who underwent successful percutaneous coronary intervention of infarct-related coronary artery (TIMI 3 flow) were collected. According to ST-T patterns in predischarge ECG, the cohort was divided into two groups: 38 patients with persistent ST elevation and/or non-negative T wave pattern (STT+), and 45 patients with negative T wave, without ST elevation (STT-). QT, QTpeak, and TpTe intervals were obtained from 5 consecutive beats of sinus rhythm 60–70 bpm between 6 a.m. and 8 a.m. from Holter recording, corrected to the heart rate (HR) with Bazett’s formula.
Results: The study groups did not differ in gender, age, or treatment. No true antiarrhythmics were given. Both QTc and TpTec were longer in STT+ patients: 459 ± 26 ms vs. 440 ± 25 ms, p = 0.01 and 108 ± 10 ms vs. 96 ± 11 ms, p = 0.000015, respectively. Prolongation of late repolarization was found both in anterior and inferior infarction.
Conclusions: STEMI patients who underwent successful percutaneous coronary intervention of infarct-related coronary arteries and demonstrated persistent ST elevation, without negative T wave at hospital discharge, had a longer repolarization duration, especially the late phase of it. Further studies are necessary to assess the prognostic value of this finding.
Abstract
Background: Negative T wave and lack of ST segment elevation in predischarge ECG in ST-segment elevation myocardial infraction (STEMI) patients are given as markers of good prognosis. Repolarization duration, especially its late part (TpeakTend - TpTe), likewise ST-T patterns, is related to local post-myocardial infarction myocardial attributes. We analyzed the differences in QT parameters in STEMI patients with negative or not-negative T wave pattern in predischarge ECG.
Methods: The data from 83 STEMI patients (LVEF > 45%, first MI, one-vessel disease) who underwent successful percutaneous coronary intervention of infarct-related coronary artery (TIMI 3 flow) were collected. According to ST-T patterns in predischarge ECG, the cohort was divided into two groups: 38 patients with persistent ST elevation and/or non-negative T wave pattern (STT+), and 45 patients with negative T wave, without ST elevation (STT-). QT, QTpeak, and TpTe intervals were obtained from 5 consecutive beats of sinus rhythm 60–70 bpm between 6 a.m. and 8 a.m. from Holter recording, corrected to the heart rate (HR) with Bazett’s formula.
Results: The study groups did not differ in gender, age, or treatment. No true antiarrhythmics were given. Both QTc and TpTec were longer in STT+ patients: 459 ± 26 ms vs. 440 ± 25 ms, p = 0.01 and 108 ± 10 ms vs. 96 ± 11 ms, p = 0.000015, respectively. Prolongation of late repolarization was found both in anterior and inferior infarction.
Conclusions: STEMI patients who underwent successful percutaneous coronary intervention of infarct-related coronary arteries and demonstrated persistent ST elevation, without negative T wave at hospital discharge, had a longer repolarization duration, especially the late phase of it. Further studies are necessary to assess the prognostic value of this finding.
Keywords
acute myocardial infarction; percutaneous coronary intervention; repolarization; transmural dispersion; ST segment; T wave
About this articleTitle
Repolarization parameters in patients with acute ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention with respect to predischarge ST-T pattern: A preliminary study
Journal
Issue
Pages
52-56
Published online
2008-11-28
Page views
772
Article views/downloads
1037
Bibliographic record
Cardiol J 2009;16(1):52-56.
Keywords
acute myocardial infarction
percutaneous coronary intervention
repolarization
transmural dispersion
ST segment
T wave
Authors
Krzysztof Szydło
Krystian Wita
Maria Trusz-Gluza
Karolina Zawada
Anna Piecuch
Anna Kulach
Ewa Kucz
Anna Tyrka
Iga Kornacka
Patrycja Trams-Stawowska
Grzegorz Pieda
