Deeply re-inverted T-wave at 14 days after the onset of first anterior acute myocardial infarction predicts improved left ventricular function at 6 months.
Deeply re-inverted T-wave at 14 days after the onset of first anterior acute myocardial infarction predicts improved left ventricular function at 6 months.
复制标题
首次前壁急性心肌梗死发病后 14 天时深度倒转的 T 波预示着 6 个月时左心室功能的改善。
DOI：
10.1002/clc.22366
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Okumura K.
中科院分区：
文献类型：
--
作者：
Yokoyama H;Tomita H;Nishizaki F;Hanada K;Shibutani S;Yamada M;Abe N;Higuma T;Osanai T;Okumura K.
背景心电图改变，尤其是ST段和T波改变，ST段抬高型急性心肌梗死（STEMI）患者经皮冠状动脉介入治疗（PCI）成功后14天，T波深度倒置预示着左心室（LV）改善。方法：我们连续招募了112例（88例男性，63 ± 11岁）首次前壁STEMI患者，他们成功接受了PCI。从入院到14天，每天记录12导联ECG。PCI后，在2天内观察到第一次T波倒置，第二次发生在14天。我们测量了再倒置T波的最大深度（Neg‐T），并根据Neg‐T的中位数将患者分为2组：深层组（≥0.6 mV，n = 62）和非深部组结果14 d时两组左室射血分数（LVEF）无差异，6个月时，深部组大于非深部组（50.0% ± 8.8%vs42.5% ± 9.8%，P< 0.0001）。深部组的最大肌酸酐磷酸激酶-心肌带（CPK-MB）值显著低于非深部组。6个月时，深部组胸前导联R波再现率高于非深部组（68%vs46%，P = 0.02）。多变量回归分析显示，Neg-T和max CPK-MB是6个月时左室射血分数的独立贡献者。结论首次前壁STEMI发作后14天T波深度再倒置可能是6个月时左室功能改善的有用预测标志物。
BackgroundChanges in electrocardiogram (ECG), especially in the ST segment and T wave, have been recognized as a noninvasive diagnostic tool for coronary flow or myocardial injury.HypothesisA deeply inverted T wave at 14 days after successful percutaneous coronary intervention (PCI) in patients with ST‐segment elevation acute myocardial infarction (STEMI) predicts improved left ventricular (LV) function at 6 months.MethodsWe enrolled 112 consecutive patients (88 men, 63 ± 11 years) with first anterior STEMI who underwent successful PCI. A 12‐lead ECG was recorded everyday from admission through 14 days. After PCI, the first T‐wave inversion was observed within 2 days, and the second occurred at 14 days. We measured the maximum depth of the reinverted T wave (Neg‐T) and divided the patients into 2 groups based on the median value of Neg‐T: the deep group (≥0.6 mV, n = 62) and the nondeep group (<0.6 mV, n = 50).ResultsLV ejection fraction (LVEF) at 14 days did not differ between the 2 groups, but it was greater in the deep than in the nondeep group at 6 months (50.0% ± 8.8% vs 42.5% ± 9.8 %,P< 0.0001). The maximum creatinine phosphokinase‐myocardial band (CPK‐MB) value was significantly lower in the deep than in the nondeep group. Reappearance of the R wave in precordial leads at 6 months was more frequently observed in the deep than in the nondeep group (68% vs 46%,P= 0.02). Multivariate regression analysis showed that the Neg‐T and max CPK‐MB were independent contributors to LVEF at 6 months.ConclusionsA deeply reinverted T wave at 14 days after onset of first anterior STEMI can be a useful predictive marker for improved LV function at 6 months.