Relation between different methods for analysing ST segment deviation and infarct size as assessed by positron emission tomography

Desmet, W.J.; Mesotten, L.V.; Maes, A.F.; Heidbüchel, H.P.; Mortelmans, L.A.; Van de Werf, F.J.

doi:10.1136/HRT.2003.012955

Title

Relation between different methods for analysing ST segment deviation and infarct size as assessed by positron emission tomography

Author

Desmet, W.J.

Mesotten, L.V.

Maes, A.F.

Heidbüchel, H.P.

Mortelmans, L.A.

Van de Werf, F.J.

Abstract

Objective: To study the relation between resolution of ST segment deviation and infarct size using positron emission tomography. Methods: 45 patients with ST segment elevation acute myocardial infarction treated with thrombolysis or percutaneous coronary intervention were studied prospectively. An ECG was taken before and at (mean (SD)) 100 (45)min after reperfusion therapy. ECGs were analysed by three methods. Residual ST segment deviation, obtained from the ECG immediately after completion of reperfusion therapy, was defined by summation for each of the three methods. Relative resolution of ST segment deviation was defined as the absolute resolution divided by the ST segment deviation score at baseline x 100 (%). After 29 (14) hours, myocardial blood flow was measured with (NH3)-N-13. For each patient, the regions with a myocardial blood flow <80% of normally perfused myocardium (=hypoperfusion) and <50% (=no reflow) were automatically delineated. Results: Substantial differences were found between different ECG analysis methods. There were moderate correlations between the area with myocardial hypoperfusion and ST segment deviation scores at baseline and after reperfusion therapy. After reperfusion therapy, residual ST segment deviation in the single lead with maximum ST segment deviation was as good at discriminating between tertiles of myocardial damage as summed ST segment elevation. Relative ST segment resolution did not discriminate between different degrees of myocardial damage. Conclusions: In the individual patient, residual ST segment deviation after reperfusion in the single lead with maximum ST segment deviation is at least as good as summed ST elevation in predicting final myocardial damage.

Language

English

Source (journal)

Heart : official journal of the British Cardiac Society / British Cardiac Society; British Cardiovascular Society [London] - London, 1996, currens

Publication

London : BMJ , 2004

ISSN

1355-6037 [print]

1468-201X [online]

DOI

10.1136/HRT.2003.012955

Volume/pages