Myocardial salvage for ST-elevation myocardial infarction with terminal QRS distortion and restoration of brisk epicardial coronary flow View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-03

AUTHORS

Nobuo Nakamura, Masahiro Gohda, Osamu Satani, Yoshiaki Tomobuchi, Yuji Ueno, Takashi Tanimoto, Hironori Kitabata, Shigeho Takarada, Takashi Kubo, Masato Mizukoshi, Kumiko Hirata, Atsushi Tanaka, Toshio Imanishi, Takashi Akasaka

ABSTRACT

Recently, it has been reported that large infarcts associated with terminal QRS distortion (QRSDIS) on the admission electrocardiograms of patients with ST-elevation myocardial infarctions (STEMIs) may be caused by a failure to achieve thrombolysis in myocardial infarction (TIMI) grade 3 flow after primary percutaneous coronary intervention (PCI). However, the relationship between QRSDIS and final infarct size when TIMI grade 3 flow could be achieved by primary PCI is still unclear. Sixty-two consecutive patients with first anterior STEMI and who achieved TIMI grade 3 flow by primary PCI were classified into two groups according to the presence (Group A, n = 18) or absence (Group B, n = 44) of QRSDIS. Two weeks after the onset of acute myocardial infarction, Group A had a larger left ventricular (LV) end-systolic volume index (LVESVI) and a lower LV ejection fraction (LVEF) than Group B (LVESVI: 38 ± 13 vs 31 ± 12 ml/m2, P = 0.025: LVEF: 42% ± 10% vs 51% ± 10%, P = 0.004). Through multivariate analysis, independent predictors of poor LV systolic function (LVEF < 40%) were determined to be the presence of QRSDIS (odds ratio 21.04, P = 0.021) and proximal left anterior descending artery occlusion (odds ratio 16.15, P = 0.033). Myocardial damage could not be reduced in patients experiencing STEMI with QRSDIS, even when TIMI grade 3 flow could be achieved by primary PCI, as much as in patients experiencing STEMI without QRSDIS. More... »

PAGES

96-102

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-008-1092-3

DOI

http://dx.doi.org/10.1007/s00380-008-1092-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052275074

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19337792


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34 schema:description Recently, it has been reported that large infarcts associated with terminal QRS distortion (QRSDIS) on the admission electrocardiograms of patients with ST-elevation myocardial infarctions (STEMIs) may be caused by a failure to achieve thrombolysis in myocardial infarction (TIMI) grade 3 flow after primary percutaneous coronary intervention (PCI). However, the relationship between QRSDIS and final infarct size when TIMI grade 3 flow could be achieved by primary PCI is still unclear. Sixty-two consecutive patients with first anterior STEMI and who achieved TIMI grade 3 flow by primary PCI were classified into two groups according to the presence (Group A, n = 18) or absence (Group B, n = 44) of QRSDIS. Two weeks after the onset of acute myocardial infarction, Group A had a larger left ventricular (LV) end-systolic volume index (LVESVI) and a lower LV ejection fraction (LVEF) than Group B (LVESVI: 38 ± 13 vs 31 ± 12 ml/m2, P = 0.025: LVEF: 42% ± 10% vs 51% ± 10%, P = 0.004). Through multivariate analysis, independent predictors of poor LV systolic function (LVEF < 40%) were determined to be the presence of QRSDIS (odds ratio 21.04, P = 0.021) and proximal left anterior descending artery occlusion (odds ratio 16.15, P = 0.033). Myocardial damage could not be reduced in patients experiencing STEMI with QRSDIS, even when TIMI grade 3 flow could be achieved by primary PCI, as much as in patients experiencing STEMI without QRSDIS.
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42 Myocardial Infarction (TIMI) grade 3 flow
43 QRS distortion
44 ST-elevation myocardial infarction
45 TIMI grade 3 flow
46 absence
47 acute myocardial infarction
48 admission electrocardiogram
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53 coronary flow
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55 damage
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57 ejection fraction
58 electrocardiogram
59 end-systolic volume index
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64 flow
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66 function
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81 myocardial damage
82 myocardial infarction
83 myocardial salvage
84 occlusion
85 onset
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88 poor LV systolic function
89 predictors
90 presence
91 primary PCI
92 primary percutaneous coronary intervention
93 relationship
94 restoration
95 salvage
96 size
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