Prediction of improvement in left ventricular function during a 1-year follow-up after acute myocardial infarction by the degree of acute resolution of electrocardiographic changes

Abstract

Background and Purpose Reperfusion therapy results in better left ventricle (LV) function in cases of successful myocardial reperfusion; however, insufficient reperfusion or reocclusion of the infarct-related artery is associated with LV dysfunction. This study was proposed to determine whether the rate of ECG stage dynamics, after mechanical, thrombolytic, or spontaneous recanalization, is a predictor of improvement in LV function. Methods Twenty-seven consecutive patients, observed for 1 year, were divided into group A (11, change rate of ≥2 ECG stages per 2 days), group B (13, no rapid change), and cases with reocclusion (3). Results Clinical and radiographic signs of heart failure tended to decrease in group A but tended to increase in other cases. Echocardiographic dyssynergic score decreased, and LV ejection fraction increased only in group A: 4.3 ± 1.2 vs 2.7 ± 1.5, P = .04, and 42.0 ± 4.8 vs 46.0 ± 8.3, P = .049, respectively; in group B, the values were 3.4 ± 2.4 vs 3.4 ± 2.2 and 44.0 ± 6.9 vs 43.8 ± 9.3, respectively. Conclusions Rapid ECG stage changes predict follow-up improvement in LV function.