Factors indicating the best reperfusion method in acute myocardial infarction: Q wave better than time of onset

To evaluate the admission electrocardiogram [ECG] patterns as prognostic factors and compare the Q wave with other criteria such as time, for choosing the best treatment in acute myocardial infarction [AMI] Prospective case-control study Cardiac Emergency Departments of Imam Reza and Qaem Hospitals, Mashhad, Iran A total of 143 consecutive patients between year 2010 and 2012, diagnosed with AMI who were candidates for reperfusion therapy were enrolled. The admission and control post-thrombolytic therapy ECGs were taken for all subjects. Then admission ECG patterns, time to therapy and their relation with the reperfusion rate were analyzed. 60.1% [n = 86] of patients achieved 50% or more ST recovery [good response group] and 39.8% [n = 57] of patients had lower than 50% ST recovery [poor response group]. The mean response rate was significantly lower in patients presenting with Q wave [p 0.023]. In patients with initial Q wave, there was no significant difference in response rate whether they were treated within three hours from the onset of symptoms or not [p = 0.75]. In contrast, patients without Q wave who received thrombolytic therapy within first three hours had significantly higher reperfusion rates in comparison with those treated after three hours [p = 0.004]. It is suggested that, time from the onset of symptoms along with initial Q wave is better for decision making in AMI management, than the time alone

Tissue doppler imaging in the assessment of myocardial systolic and diastolic functions in patients with stable angina pectoris

Coronary artery diseases affect both systolic and diastolic functions and can be assessed both globally and regionally. Tissue doppler imaging is a novel technique with additional advantages to the currently used twodimensional echocardiography. This paper is a review of the published articles on documented Coronary artery diseases patients confirmed by angiography, without any previous myocardial infarction and with normal left ventricular ejection fraction. Accordingly, a significant relationship was achieved between systolic rather than diastolic parameters with Coronary artery diseases. Furthermore, major heterogeneity was noticed among the available studies in this respect. The incremental values of tissue doppler imaging in patients with stable angina in addition to other non invasive tests has led to its recommendation by ACC/AHA