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Unlabelled: The aim of our study was to define a predictive value of ST-segment resolution after coronary reperfusion for early and late left ventricular (LV) function. We also studied its relation to angiographic marker of myocardial reperfusion, myocardial blush grade (MBG)., Materials and Methods: Study population consisted of 105 patients (75 men, 30 women, mean age 62+/-13 years) treated with primary PTCA for anterior myocardial infarction (AMI) within 12 hours from symptoms onset. ECG was performed before - and 30 min. after PTCA. We evaluated angiographic markers of recanalization (TIMI, corrected TIMI frame count) and myocardial reperfusion - MBG. Echocardiography was performed 3 days and 6 months after AMI. Patients were divided into 2 groups regarding reduction -50% in ST segment elevation after recanalization (rST): group I (n=37) with rST, and group 2 (n=68) without rST RESULTS: In group I we noticed higher CPK level (2890,2+/-2404,2 U/I vs. 3980,9+/-2812,2 U/I, p<0,01). MB grade 3 was significantly more often found in group 1 at 29 pts (78,4%) than in group 2 at 18 pts (23,5%), p<0,0001. MG grade 0 or 1 were more often in group 2 (57,3% vs. 2,7%, p<0,01). Ejection fraction (EF) was higher in group 1 after 3 days (48,9+/-9,5% vs. 44,2+/-14,3%, p<0,01), as well as after 6 months (56,4+/-14,4% vs. 49,5+/-14,3%, p=0,001). After 6 months end-diastolic volume (EDV) was higher in group 2 (128,1+/-46,1 ml vs. 110,2+/-49,7 ml, p<0,008)., Conclusions: ST-resolution after successful PTCA is a simple and effective marker of myocardial reperfusion after recanalization which correlates with angiographic markers of tissue reperfusion. Early ST-segment resolution is connected with better early and late LV function. Patients without early ST-segment elevation resolution have a higher risk of LV remodelling.

Unlabelled: The benefit of thrombolysis in acute myocardial infarction (AMI) is time dependent, but there is lack of evidence of such a close correlation in patients undergoing primary percutaneous transluminal coronary angioplasty (pPTCA). The aim of this study was to evaluate the importance of delay of treatment for myocardial reperfusion and early and late ventricular function in patients with anterior AMI treated with pPTCA., Methods: 106 consecutive patients (76 men, 30 women, age 63 +/- 11 years) treated with pPTCA for anterior AMI was included in this study. We evaluated angiographic (myocardial blush grade (MBG), TIMI flow, corrected TIMI frame count) and electrocardiographic (resolution of ST segment elevation--nST) markers of myocardial reperfusion. Echocardiography was performed 3 and 180 days after pPTCA. End-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction were calculated. Patients were divided into three groups: group A (41 pts.) reperfused within 3 hours, group B (40 pts.) reperfused between 3-6 hours, group C (25 pts.) reperfused between 6-12 hours from symptoms onset., Results: MBG 0-1 (lack of myocardial reperfusion) was significantly more common in group B and C, compared with group A (p = 0.002). The incidence of nST was higher in group A (p < 0.0001). The EF after 3 days (p = 0.03) and after 6 months (p = 0.04) was better in group A in comparison to group C. There was not significant difference in EDV after 3 days, but after 6 months EDV was significantly higher in group C (p = 0.02)., Conclusions: The delay of treatment over 3 hours is associated with decreasing of myocardial reperfusion efficacy and deterioration of the early and late LV function.