Significance of exercise-induced ST segment elevation in Q leads in patients with a recent myocardial infarction and an open infarct-related artery Analysis with angiography, intracoronary myocardial contrast echocardiography and cardiac magnetic resonance

The significance of exercise-induced ST segment elevation in Q leads in patients with a recent myocardial infarction and without significant residual stenosis in the infarct-related artery has not been defined. We aimed to elucidate the role of myocardial perfusion and viability in this scenario. Si...

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Bibliographic Details
Published in:International journal of cardiology 2005-08, Vol.103 (1), p.85-91
Main Authors: BODI, Vicent, SANCHIS, Juan, LLACER, Angel, LOPEZ-LEREU, Maria P, LOSADA, Antonio, PELLICER, Mauricio, GARCIA, Diego, NUNEZ, Julio, CHORRO, Francisco J
Format: Article
Language:English
Subjects:
Angioplasty, Balloon, Coronary
Biological and medical sciences
Cardiac Catheterization
Cardiology. Vascular system
Contrast Media - administration & dosage
Coronary Angiography
Coronary Circulation - physiology
Coronary heart disease
Coronary Vessels
Echocardiography - methods
Electrocardiography
Exercise Test
Female
Follow-Up Studies
Galactose - administration & dosage
Heart
Humans
Injections, Intra-Arterial
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Myocardial Contraction - physiology
Myocardial Infarction - diagnosis
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
Myocarditis. Cardiomyopathies
Prognosis
Prospective Studies
Severity of Illness Index
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Summary:The significance of exercise-induced ST segment elevation in Q leads in patients with a recent myocardial infarction and without significant residual stenosis in the infarct-related artery has not been defined. We aimed to elucidate the role of myocardial perfusion and viability in this scenario. Sixty-six patients with a first myocardial infarction, single-vessel disease and an open artery were studied. Myocardial perfusion was assessed with angiographic blush, intracoronary myocardial contrast echocardiography and magnetic resonance. Myocardial viability was quantified by means of magnetic resonance (transmural extent of necrosis). Exercise-induced ST elevation in Q leads was observed only in 13 cases (20%); 53 patients (80%) did not show this finding. The group with ST elevation had fewer cases with normal perfusion: Blush 3 (15% vs. 74%, p=0.001), myocardial contrast echocardiography score >0.75 (8% vs. 81%, p=0.001) and magnetic resonance score >0.75 (31% vs. 68%, p=0.03). Similarly, myocardial viability (necrosis
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2004.08.022