Relation between ST-segment changes and myocardial perfusion evaluated by myocardial contrast echocardiography in patients with acute myocardial infarction treated with direct angioplasty

Santoro, Giovanni Maria; Valenti, Renato; Buonamici, Piergiovanni; Bolognese, Leonardo; Cerisano, Giampaolo; Moschi, Guia; Trapani, Maurizio; Antoniucci, David; Fazzini, Pier Filippo

doi:10.1016/s0002-9149(98)00508-6

Cited by 223 publications

(126 citation statements)

References 35 publications

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“…5 Reduction in ST-segment elevation index was defined as a ≥ 50% decrease 1 h after recanalization of the IRA.…”

Section: Electrocardiographic Datamentioning

confidence: 99%

“…1 Angiographic MBG, cTFC, and ST-segment elevation index are parameters easily obtainable to evaluate myocardial reperfusion. [5][6][7][8] Myocardial blush is related to the enzymatic infarct size, the extent of ST-segment elevation resolution, LV function, and long-term mortality in patients with AMI after primary PCI, 7 as well as to the final infarct size and the degree of myocardial salvage assessed by scintigraphy. 12, 14 The cTFC has been suggested to be an independent predictor of functional recovery, in-hospital, and 1-month clinical outcome.…”

Section: Previous Studiesmentioning

confidence: 99%

“…12, 14 The cTFC has been suggested to be an independent predictor of functional recovery, in-hospital, and 1-month clinical outcome. 8,13 ST-segment elevation persistence despite a patent IRA is a predictor of higher in-hospital and long-term mortality, 5 while its early resolution after reperfusion correlates with myocardial salvage, final infarct size, and 6-month mortality. 15 In this study, LV function recovery was more often observed in patients with a better myocardial reperfusion as assessed by MBG and ST-segment elevation index 1 h after PCI.…”

Section: Previous Studiesmentioning

confidence: 99%

“…Some reperfusion parameters can be obtained by myocardial contrast echocardiography, Doppler flow wire, myocardial scintigraphy, and magnetic resonance imaging; however, their application is difficult and time consuming. [1][2][3][4] On the other hand, the resolution of ST-segment elevation, 5,6 the angiographic myocardial blush grade (MBG), 6,7 and the corrected Thrombolysis In Myocardial Infarction (TIMI) frame count (cTFC) 8 are early and easily obtainable during the acute stage of AMI treated with primary coronary intervention (PCI) .…”

Section: Introductionmentioning

confidence: 99%

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Markers of myocardial reperfusion as predictors of left ventricular function recovery in acute myocardial infarction treated with primary angioplasty

Bellandi

Leoncini

Maioli

et al. 2004

Clinical Cardiology

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SummaryBackground: Myocardial blush grade (MBG), corrected TIMI frame count (cTFC), and ST-segment reduction are indices of myocardial reperfusion.Hypothesis: We evaluated their predictive value for left ventricular (LV) function recovery by gated single-photon emission computed tomography (SPECT) after acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI).Methods: In 40 patients with AMI, gated SPECT was performed at admission and repeated 7 and 30 days after PCI. Left ventricular function recovery was defined as an increase ≥ 10 points in SPECT LV ejection fraction from baseline to 1 month. The MBG, cTFC, and ST-segment elevation index 1 h after PCI were determined to evaluate reperfusion.Results: Twenty-four patients (Group 1) had LV function recovery and 16 (Group 2) did not. A significant correlation was found between LV function recovery and MBG (r = 0.66; p = 0.0001), and ST-segment elevation index at 1 h (r = Ϫ0.55; p = 0.0001), but not with cTFC. Univariate predictors of LV function recovery were MBG (p = 0.0003) and ST-segment elevation index 1 h after intervention (p = 0.0026), but not cTFC. In a multivariate analysis, MBG was the only predictor of LV function recovery. Myocardial blush grade ≥ 2 and STsegment elevation index reduction had the same accuracy

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“…5 Reduction in ST-segment elevation index was defined as a ≥ 50% decrease 1 h after recanalization of the IRA.…”

Section: Electrocardiographic Datamentioning

confidence: 99%

Section: Previous Studiesmentioning

confidence: 99%

Section: Previous Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Markers of myocardial reperfusion as predictors of left ventricular function recovery in acute myocardial infarction treated with primary angioplasty

Bellandi

Leoncini

Maioli

et al. 2004

Clinical Cardiology

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“…They should be monitored for a minimum of 24 hours and until they remain event-free for 12 to 24 hours. The potential benefits in patients with acute MI include the ability to (1) assess patency of the culprit artery after thrombolytic therapy [57][58][59][60][61] ; (2) detect abrupt reocclusion after primary angioplasty 62 ; (3) detect ongoing ischemia (ie, failed reperfusion therapy), recurrent ischemia, and infarct extension; and (4) detect transient myocardial ischemia. ST-segment monitoring stud-ies of patients hospitalized with unstable angina show that although 80% to 90% of transient ischemic events are asymptomatic, they are nonetheless significant markers for unfavorable short-and long-term outcomes (Table 2).…”

Section: Patients In the Early Phase Of Acute Coronary Syndromes (St-mentioning

confidence: 99%

Practice Standards for ECG Monitoring in Hospital Settings: Executive Summary and Guide for Implementation

Drew

Funk

2006

Critical Care Nursing Clinics of North America

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Abstract-The goals of electrocardiographic (ECG) monitoring in hospital settings have expanded from simple heart rate and basic rhythm determination to the diagnosis of complex arrhythmias, myocardial ischemia, and prolonged QT interval. Whereas computerized arrhythmia analysis is automatic in cardiac monitoring systems, computerized ST-segment ischemia analysis is available only in newer-generation monitors, and computerized QT-interval monitoring is currently unavailable. Even in hospitals with ST-monitoring capability, ischemia monitoring is vastly underutilized by healthcare professionals. Moreover, because no computerized analysis is available for QT monitoring, healthcare professionals must determine when it is appropriate to manually measure QT intervals (eg, when a patient is started on a potentially proarrhythmic drug). The purpose of the present review is to provide 'best practices' for hospital ECG monitoring. Randomized clinical trials in this area are almost nonexistent; therefore, expert opinions are based upon clinical experience and related research in the field of electrocardiography. This consensus document encompasses all areas of hospital cardiac monitoring in both children and adults. The emphasis is on information clinicians need to know to monitor patients safely and effectively. Recommendations are made with regard to indications, timeframes, and strategies to improve the diagnostic accuracy of cardiac arrhythmia, ischemia, and QT-interval monitoring. Currently available ECG lead systems are described, and recommendations related to staffing, training, and methods to improve quality are provided. Key Words: AHA Scientific Statements Ⅲ pediatrics Ⅲ electrocardiography Ⅲ torsade de pointes Ⅲ myocardial infarction Ⅲ tachyarrhythmias Ⅲ ischemia Ⅲ antiarrhythmic agents Ⅲ long-QT syndrome S ince the introduction of electrocardiographic (ECG) monitoring in hospital units Ͼ40 years ago, 1 the goals of monitoring have expanded from simple tracking of heart rate and basic rhythm to the diagnosis of complex arrhythmias, the detection of myocardial ischemia, and the identification of a prolonged QT interval. During the same 4 decades, major improvements have occurred in cardiac monitoring systems, including computerized arrhythmia detection algorithms, STsegment/ischemia monitoring software, improved noisereduction strategies, multilead monitoring, and reduced lead sets for monitoring-derived 12-lead ECGs with a minimal number of electrodes. 2,3 Despite these advances in technology, the need for human oversight in the interpretation of ECG monitoring data is as important today as it was 40 years ago for the following reasons. First, cardiac monitor algorithms are intentionally set for high sensitivity at the expense of specificity. As a result, numerous false alarms occur that must be evaluated by healthcare professionals so that overtreatment of patients will not occur. Examples of overtreatment are reported in the The American Heart Association makes every effort to avoid any actual or potential co...

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References

2007

The Surface Electrocardiography in Ischaemic Heart Disease

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Relation between ST-segment changes and myocardial perfusion evaluated by myocardial contrast echocardiography in patients with acute myocardial infarction treated with direct angioplasty

Cited by 223 publications

References 35 publications

Markers of myocardial reperfusion as predictors of left ventricular function recovery in acute myocardial infarction treated with primary angioplasty

Markers of myocardial reperfusion as predictors of left ventricular function recovery in acute myocardial infarction treated with primary angioplasty

Practice Standards for ECG Monitoring in Hospital Settings: Executive Summary and Guide for Implementation

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