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Functional and Structural Correlates of Persistent ST Elevation After Acute Myocardial Infarction Successfully Treated by PCI
  1. Leonarda Galiuto (lgaliuto{at}rm.unicatt.it)
  1. Catholic University of the Sacred Heart, Italy
    1. Sabrina Barchetta
    1. Catholic University of the Sacred Heart, Italy
      1. Serena Paladini
      1. University of Siena, Italy
        1. Gaetano Lanza
        1. Catholic University of the Sacred Heart, Italy
          1. Antonio G Rebuzzi
          1. Catholic University of the Sacred Heart, Italy
            1. Mario Marzilli
            1. University of Siena, Italy
              1. Filippo Crea
              1. Catholic University of the Sacred Heart, Italy

                Abstract

                Background In the thrombolytic era, persistence of ST-segment elevation was considered a marker of LV aneurysm. ST-segment elevation may still be found persistently elevated after successful primary PCI. Echocardiographic correlates of this finding, however, are still poorly known.

                Methods and Results Eighty-two consecutive patients with first STEMI and successful PCI were divided in patients with persistent ST- segment elevation at discharge (sum of ST > 4 mm) (n=33) and without persistent ST- segment elevation (n=49). Conventional and myocardial contrast echocardiography (MCE) were performed at discharge and at 6 months. At discharge, LV aneurysm was more frequent in persistent ST-elevation patients (30%, p<0.005). Similarly, WMSI was higher (p<0.005) and microvascular damage larger (p<0.005) in patients with persistent ST-segment elevation. At 6 months follow-up, LV volumes were similar in the two groups.

                Conclusions After primary PCI, persistent ST-segment elevation is associated with LV aneurysm formation in 30% of cases, it is not associated with significantly larger LV dilation but with larger microvascular damage and dysfunctioning risk area.

                • Microcirculation
                • Microvascular Dysfunction
                • Myocardial Infarction

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