ST-segment re-elevation unrelated to left ventricular ejection fraction or volume after anterior wall acute myocardial infarction treated with successful reperfusion

Abstract Ventricular remodeling is a major determinant of the long-term prognosis of patients with acute myocardial infarction (AMI). No previous study examined the relation of ST-segment re-elevation to left ventricular (LV) volume and function in patients with successful reperfusion. We examined the relation of ST-segment re-elevation to LV function and volume indices in 51 patients with anterior wall AMI who underwent successful reperfusion by direct coronary angioplasty. A 12-lead electrocardiogram was recorded once a day until 7 days after the onset of AMI. ST-segment shift was measured and [Sigma ]ST was defined as the sum of ST-segment elevation obtained from leads V2, V3, and V4. ST-segment re-elevation was defined as present when the difference between maximal and minimal [Sigma ]ST ([utri ]ST) was [gt ]0.3mV. LV indices were obtained from left ventriculography performed approximately 1 month after the onset of AMI. ST-segment re-elevation was observed in 15 patients (29%). No significant differences were observed between the ST- re-elevation group and non[ndash ]ST-re-elevation group in LV ejection fraction (49.4[plusmn]14.0 vs. 51.2[plusmn]11.5%), LV end-systolic volume index (35.8[plusmn]13.1 vs. 33.8[plusmn]12.5 mL/m 2 ) or LV end-diastolic volume index (69.7[plusmn]12.8 vs. 68.3[plusmn]14.4 mL/m 2 ). The difference between maximal and minimal [Sigma ]ST ([utri ]ST) was not significantly correlated with any LV index examined. In conclusion, the present study revealed that ST-segment re-elevation after successful reperfusion in anterior wall AMI patients was not related to LV volume or function, indicating that ST-re-elevation is not a clinically meaningful indicator of LV remodeling.