effect of precordial st-segment depression in inferior st-segment elevation myocardial infarction on left ventricular systolic function: two-dimensional echocardiographic study

ABSTRACT

The importance of precordial ST-segment depression in patients with early inferior ST-segment elevation myocardial infarction remain unclear. Many studies have reported that patients with precordial ST-segment depression appear to have large infarctions. The objectives of this study was to evaluate the effect of precordial ST-segment depression in patients with early inferior ST-segment elevation myocardial infarction on the left ventricular systolic function and left ventricular regional wall abnormalities. Fifty eight patients with first inferior ST-segments elevation myocardial infarction [37 male, 21 femal] their ages ranged from 30-91 year, mean age 60.59 +/- 11.21 who underwent thrombolysis in the Coronary Care Unit of Erbil Teaching Hospital for the period from August 2008 to August 2009 were included in this study. Two-dimensional echocardiography was performed in the first week of acute inferior myocardial infarction. Patients were classified according to the absence [group 1, 30, 51.72%] or presence [group II, 28, 48.28%] of precordial ST- segment depression. Group-ll patients had a higher significant incidence of left ventricular systolic dysfunction [8, 28.57%] than group I [2, 6.67%], P=0.027 .despite thrombolytic therapy [alteplase]. Group-ll patients had higher significant incidence of left ventricular regional wall abnormalities [12, 42.9%] than group-l [3, 10%], P 0.00 .despite thrombolytic therapy [alteplase]. Early two-dimensional echocardiography is recommended for patients with inferior ST-segment elevation myocardial infarction associated with precordial ST-segment depression for the earliest detection of regional wall abnormalities and left ventricular systolic dysfunction