Changes of electrocardiographic and echocardiographic data after early and late mechanical recanalization of infarct-related artery with and without stent implantation

Abstract

Correspondence to E. Kalinauskienė,

T-Wave Normalization during Follow-Up After Early and Late Mechanical Recanalization of Infarct-Related Artery With and Without Stent Implantation

“…Our previous study reported the changes in the QRS score and echocardiographic characteristics at hospital and at the 3-month follow-up in the same cohort (15). Now we have added the data on T-wave recovery as well as additional 3 months of follow-up.…”

“…A total of 248 consecutive patients were divided into the following groups: early angioplasty (≤24 hours) without stents (n=114) or with stents (n=6) and late angioplasty (>24 hours) without stents (n=114) or with stents (n=14). Serial 12-lead ECGs, recorded at admission, on the first day after PCI, at discharge, and after 3 and 6 months, were analyzed, and 4 ECG stages of AMI were defined by the same criteria (17) as in our previous study (15), and an additional stage V suggested by us was added: • Stage I, the ST-segment elevation ≥0.1 mV, a positive T wave, and normal Q wave; • Stage II, the ST-segment elevation ≥0.1 mV, abnormal Q wave. In accordance with the Selvester QRS scoring system (18), Q wave was considered abnormal if it was present in leads V1, V2, V3 or it was ≥20 ms in lead V4 or it was ≥30 ms in any other lead except III and aVR; • Stage III, the ST segment is still elevated, but a negative T wave begins to form; • Stage IV, the ST segment is in an isoelectric line with the negative T wave; • Stage V, the ST segment is in an isoelectric line and again positive T wave (19).…”

“…However, its value in the followup period is less clear, since it was shown that the QRS normalization during a 1-year follow-up was unaffected by an aggressive treatment strategy with revascularization via balloon angioplasty or bypass surgery (14). Previously, we have reported that the QRS score might be not predictive of improvement in LV ejection fraction at follow-up (15,16). Thus, our aim was not only to show differences in the normalization of T waves after early and late mechanical recanalization of IRA with and without stent implantation, but also to compare the evolution of T wave and QRS score with the changes of LV ejection fraction at follow-up.…”