PMID- 14559132
OWN - NLM
STAT- MEDLINE
DCOM- 20040427
LR  - 20190816
IS  - 0167-5273 (Print)
IS  - 0167-5273 (Linking)
VI  - 91
IP  - 2-3
DP  - 2003 Oct
TI  - Relationship between myocardial viability and the predischarge 
      electrocardiographic pattern in patients with first anterior wall acute 
      myocardial infarction.
PG  - 209-14
AB  - BACKGROUND: The assessment of residual viability in the infarcted area after an 
      acute myocardial infarction is relevant to subsequent management and prognosis. 
      OBJECTIVE: The aim of this study was to investigate the correlation between 
      myocardial viability after an acute anterior myocardial infarction (AMI) as 
      assessed by low dose dobutamine stress echocardiography (LDDSE) and the 
      electrocardiographic patterns of ST segment and T wave abnormalities at the end 
      of the first week of the acute event. METHODS: Sixty-nine consecutive patients 
      (51 men, 18 women, mean age+/-standard deviation=57+/-11 years) who admitted to 
      our clinic due to a first episode of transmural AMI were included in this study. 
      Two-dimensional echocardiography was performed to all patients during rest and 
      low dose dobutamine administration at the end of the first week of admission 
      (7+/-2 days). Patients were classified into four groups according to ST segment 
      and T wave morphology: group A, ST elevation < or =0.1 mV and negative T waves; 
      group B, ST elevation < or =0.1 mV and positive T waves; group C, ST elevation > 
      or =0.1 mV and negative T waves and group D, ST elevation > or =0.1 mV and 
      positive T waves. RESULTS: Myocardial viability was detected more often in 
      patients with isoelectric ST segments (22/24, 92%) than those with elevated ST 
      segments (21/45, 47%) (P<0.001). Similarly patients with negative T waves had 
      myocardial viability more frequently compared to those with positive T waves 
      (32/45, 71% vs. 11/24, 46%, P<0.01). Seventeen (94%) of 18 patients in group A 
      and 5 (83%) of six patients in group B had viable myocardium (P>0.05). Myocardial 
      viability was found in 15 (56%) of 27 patients in group C and six (33%) of 18 
      patients in group D (P<0.01). As a marker of viable myocardium, isoelectricity of 
      ST segment was specific (92%) but only moderately sensitive (51%), with a 92% 
      positive predictive accuracy and a poor (53%) negative predictive value. T wave 
      negativity was less specific but more sensitive than isoelectricity of ST segment 
      for myocardial viability. CONCLUSION: The presence of isoelectric ST segment and 
      negative T wave indicates a high probability of myocardial viability. However, 
      absence of these electrocardiographic patterns does not exclude the presence of 
      viable myocardium.
FAU - Atak, Ramazan
AU  - Atak R
AD  - Turkiye Yuksek Ihtisas Hospital, Department of Cardiology, Ankara, Turkey. 
      hratak@yahoo.com
FAU - Turhan, Hasan
AU  - Turhan H
FAU - Senen, Kubilay
AU  - Senen K
FAU - Ileri, Mehmet
AU  - Ileri M
FAU - Yetkin, Ertan
AU  - Yetkin E
FAU - Ozbakir, Cemal
AU  - Ozbakir C
FAU - Demirkan, Deniz
AU  - Demirkan D
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Aged
MH  - Echocardiography, Stress
MH  - Electricity
MH  - *Electrocardiography
MH  - Female
MH  - Heart Ventricles/diagnostic imaging/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnostic imaging/*physiopathology
MH  - Myocardium/*pathology
MH  - *Patient Discharge
MH  - Predictive Value of Tests
MH  - Sensitivity and Specificity
MH  - Statistics as Topic
MH  - Stroke Volume/physiology
EDAT- 2003/10/16 05:00
MHDA- 2004/04/28 05:00
CRDT- 2003/10/16 05:00
PHST- 2003/10/16 05:00 [pubmed]
PHST- 2004/04/28 05:00 [medline]
PHST- 2003/10/16 05:00 [entrez]
AID - S0167527303000299 [pii]
AID - 10.1016/s0167-5273(03)00029-9 [doi]
PST - ppublish
SO  - Int J Cardiol. 2003 Oct;91(2-3):209-14. doi: 10.1016/s0167-5273(03)00029-9.