Myocardial viability in patients with thrombolyzed myocardial infarction: Is it assessable by predischarge exercise electrocardiography test?

Citation
Ba. Samad et al., Myocardial viability in patients with thrombolyzed myocardial infarction: Is it assessable by predischarge exercise electrocardiography test?, CLIN CARD, 24(1), 2001, pp. 21-25
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
CLINICAL CARDIOLOGY
ISSN journal
0160-9289 → ACNP
Volume
24
Issue
1
Year of publication
2001
Pages
21 - 25
Database
ISI
SICI code
0160-9289(200101)24:1<21:MVIPWT>2.0.ZU;2-5
Abstract
Background: Most studies concerning exercise electrocardiography (ECG) test ing after acute myocardial infarction (AMI) were carried out in the prethro mbolytic era. ST-segment elevation in the infarction area during exercise h as usually been interpreted as indicating the presence of dyskinesia as a r esult of extensive left ventricle damage. Hypothesis: This study was undertaken to evaluate the contributions of exer cise-induced ST-segment elevation and T-wave pseudonormalization to the ass essment of myocardial viability in patients with thrombolyzed myocardial in farction (MI), compared with low-dose dobutamine echocardiography. Methods: The study comprised 52 consecutive patients with AMI treated with thrombolysis. All patients underwent low-dose dobutamine echocardiography a nd symptom-limited exercise testing before discharge. Results: Nineteen patients showed ST-segment elevation (Group 1), 9 showed isolated T-wave pseudonormalization (Group 2), and 24 patients did not exhi bit either of these ST-T segment changes (Group 3). Low-dose dobutamine ech ocardiography revealed evidence of viability in 16 patients (84%) in Group 1 (p = 0.01), 5 (56%) in Group 2 (p = NS), and I I patients (46%) in Group 3 (p = NS). Conclusion: Exercise-induced ST-segment elevation may contribute to the eva luation of myocardial viability in patients with AMI treated with thromboly sis. However, in the absence of exercise-induced ST-segment elevation, furt her noninvasive studies might be indicated to assess myocardial viability.