Dynamics of the myocardial structural and functional state in patients with non Q-wave myocardial infarction during 3 and 6 months follow-up in connection with percutaneous angioplasty

2018 ◽  
Vol 24 (2) ◽  
pp. 4-9
Author(s):  
V.P. Ivanov V.P. ◽  
◽  
O.V. Shcherbak ◽  
V.Yu. Maslovskyi ◽  
V.P. Shcherbak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Functional State ◽  
Percutaneous Angioplasty ◽  
Q Wave

scholarly journals Left ventricle remodeling electrocardiography criteria of survival assessment in Q-wave myocardial infarction patients

2013 ◽  
Vol 94 (2) ◽  
pp. 168-175
Author(s):  
G M Khayrutdinova
Keyword(s):  
Myocardial Infarction ◽  
Overall Survival ◽  
Left Ventricle ◽  
Alcohol Intoxication ◽  
Heart Diseases ◽  
Survival Rates ◽  
Cardiac Events ◽  
Left Ventricle Remodeling ◽  
Q Wave

Aim. To study the survival in patients with Q-wave myocardial infarction depending on features of left ventricle remodeling on electrocardiography. Methods. 10-year overall survival and heart diseases associated survival rates depending on features of left ventricle remodeling on electrocardiography were studied in 87 patients who had survived an acute myocardial infarction with Q wave. The first group included 45 patients who fulfilled electrocardiographic criteria for left ventricle adaptive remodeling, the second group included 42 patients with electrocardiographic features of left ventricle maladaptive remodeling. The survival in both groups was estimated using the Kaplan-Meier’s curves. Results. There was a highly significant inverse relationship between age and survival rate of the patients with Q-positive myocardial infarction. 40 patients succumbed by the end of the observation period, among them - 20 (50%) due to heart diseases. 20 (50%) patients died from non-cardiac events, among them - ischaemic stroke, neoplasms and accidents (most common - alcohol intoxication, 5,8% each). Chronic heart failure was most common reason of death in both groups, and it prevailed in the group of patients with left ventricle maladaptive remodeling electrocardiographic features. According to the gained data, there were no significant differences observed in overall survival in both groups during the whole follow-up period. In assessment of survival associated with heart diseases, the differences close to the statistically significant were found. Conclusion. The comparison of the overall survival depending on left ventricle remodeling electrocardiographic features did not detect any reliable differences, while in case of heart diseases associated survival assessment differences close to the statistically significant were found.

scholarly journals One year follow-up of the ESSENCE trial (enoxaparin versus heparin in unstable angina and non-Q-wave myocardial infarction)

1998 ◽  
Vol 31 ◽  
pp. 79 ◽  
Author(s):  
M. Cohen ◽  
F. Bigonzi ◽  
V. Le louer ◽  
F. Gosset ◽  
G.J. Fromell ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
One Year ◽  
Q Wave

Prognostic value of initial QRS analysis in acute anterior myocardial infarction: correlation with left ventricular systolic dysfunction, serum biomarkers, and cardiac outcomes

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Lopez Castillo ◽  
A Acena ◽  
A.M Pello-Lazaro ◽  
V Viegas ◽  
B Merchan-Munoz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Prognostic Value ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Qrs Complex ◽  
Ventricular Systolic Dysfunction ◽  
Index Event ◽  
Q Wave

Abstract Background The electrocardiogram (ECG) is an important tool for managing patients with suspected acute myocardial infarction (MI). As it is simple, cost-effective, and fast to use, great effort has been made to study its components for possible use in assessing the prognosis of patients with MI. Our study aim is to evaluate the prognostic value of specific characteristics of QRS complex and pathologic Q waves observed on the ECG of patients with anterior ST elevated myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods We prospectively analyzed the specific characteristics of QRS complex and pathologic Q waves on the first ECG obtained upon presentation to the hospital (admission ECG) and the last ECG before discharge (discharge ECG). We correlated these findings with the development of left ventricular systolic dysfunction (LVSD) 6 to 9 months after the index event, appearance of heart failure (HF) or death during follow-up, and levels of several biomarkers obtained 6 months after the index event. Results We included a total of 144 patients with anterior STEMI. Mean age was 61.3±12.5 years and 80% of patients studied were men. Hypertension was present in 48%, and Diabetes mellitus in 19%. Mean left ventricular ejection fraction was 43.83±9.92. On admission ECG mean QRS width was 97.71±19.42 milliseconds and on discharge ECG it was 96.84±18.75. Ninety-one percent of the patients underwent PCI and revascularization was considered to be complete in 79% of the patients. Multivariate logistic regression analysis revealed that on admission ECG, QRS width [OR 1.056 (1.022–1.092) p=0.001] and the sum of Q-wave depth [OR 1.062 (1.022–1.102) p=0.002] were independent predictors of LVSD development. After a median follow up of 2.9±1.5 years, 12 patients (8.4%) developed cardiovascular events, defined as HF or death. Specifically, QRS width on admission ECG, was related to an increased risk of HF or death [HR 1.03, p=0.004]. Regarding biomarkers, QRS width on admission ECG revealed a statistically significant relationship with levels of NT-pro-BNP at 6 months [0.29 (2.95–15.54) p=0.004]. Moreover, the sum of Q-wave depth [0.268 (0.000–0.001) p=0.012] and the sum of Q-wave width [0.247 (0.00–0.00) p=0.021] on admission ECG were related to levels of hs-cTnT at 6 months. The sum of the voltages in precordial leads both on admission ECG [−0.256 (−0.436 to −0.057), p=0.011] and discharge ECG [−0.236 (−0.485 to −0.004), p=0.046] were related to lower levels of PTH at 6 months. Conclusion Our study suggests that in patients suffering from anterior STEMI, specific electrocardiographic parameters at baseline and discharge, such as QRS width and pathological Q-wave depth and width, may predict the development of LVSD at 6 months and the rise in several biomarkers associated with increased CV risk. QRS width on the presentation ECG seems to be an early predictor of HF or death after anterior wall STEMI. Funding Acknowledgement Type of funding source: None

scholarly journals Full recovery of contraction late after acute myocardial infarction: determinants and early predictors

Heart ◽  
2001 ◽  
Vol 85 (5) ◽  
pp. 521-526
Author(s):  
P Lancellotti ◽  
A Albert ◽  
C Berthe ◽  
L A Piérard
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Full Recovery ◽  
Contractile Reserve ◽  
Partial Recovery ◽  
Independent Variables ◽  
Infarct Related Artery ◽  
Late Recovery ◽  
Q Wave

OBJECTIVESTo assess the relative value of electrocardiographic, echocardiographic, angiographic, and in-hospital therapeutic indices for predicting late functional recovery after acute myocardial infarction, and to determine the variables associated with absence of recovery, partial recovery, and full recovery.DESIGNProspective observational follow up study.SETTINGTeaching hospital.PATIENTS74 consecutive patients with a first uncomplicated acute myocardial infarct.INTERVENTIONSDobutamine–atropine stress echocardiography was performed mean (SD) 5 (2) days after the acute event. Quantitative angiography was available in all patients before hospital discharge. A follow up resting echocardiogram was obtained 12 (2) months later.RESULTSFunctional recovery (partial, n = 18; full, n = 27) was observed in 45 of the 74 patients. Recovery was associated with earlier thrombolytic treatment (p = 0.008), earlier peak concentration of creatine kinase (p = 0.009), greater contractile reserve (p = 0.0001), non-Q wave acute myocardial infarction (p = 0.002), and more frequent elective angioplasty of the infarct related vessel (p = 0.0004). Three independent variables were selected stepwise from multivariate analysis for predicting late recovery: contractile reserve (χ2 = 24.2, p < 0.0001); non-Q wave infarction (χ2 = 15.7, p = 0.0001); and the time from symptom onset to thrombolysis (χ2 = 4.94, p = 0.026). Three independent variables predicted full recovery: contractile reserve (χ2 = 17.2, p = 0.0001); non-Q wave infarction (χ2 = 10.1, p = 0.0016); and elective angioplasty of the infarct related artery (χ2 = 4.53, p = 0.033). Only contractile reserve (χ2 = 17.0, p < 0.001) was selected from the multivariate analysis for its ability to distinguish between partial recovery and absence of recovery.CONCLUSIONSLate recovery of contraction relates to earlier treatment, which is associated with lower infarct size unmasked by a non-Q wave event and the presence of contractile reserve. Elective coronary angioplasty of the infarct related artery before hospital discharge is associated with full recovery.

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