Echocardiographic evaluation of post MI patients with consistent ST segment elevation who underwent angiography: a follow up study

Introduction: Percutaneous intervention(PCI) is an accepted method of reperfusion in patients with acute ST-segment elevation myocardial infarction (STEMI). Establishing coronary blood flow during angiography does not always result in proper cardiac circulation. There are many factors related to patient outcomes after primary PCI. ST-segment resolution (STSR) is one of these factors that can be achieved noninvasively and indicates reperfusion. However, the relationship between STSR and echocardiographic findings is not widely studied. The aim of the present study is to evaluate electrocardiogram (ECG) and echocardiography findings in post-STEMI patients undergoing PCI. Materials and methods: A total of 340 patients who had STEMI and underwent successful PCI were chosen by convenience sampling and enrolled in this follow up study. After considering the exclusion criteria, 12-lead ECG was performed on each patient at 60min, 90min, 120min, 24 h and 2 months after PCI. Additionally,a transthoracic echocardiogram (TTE) was performed after PCI, and 2 additional TTEs were performed—one each at 24 hpost-PCI and 2 months after PCI. ST-segment resolution was evaluated in every ECG, and the results were compared with the TTE findings. Results: The mean±SD for the time duration between the onset of symptoms and calling EMS, the door-to-balloon time, and the time duration between the first medical staff visit andangioplasty were 114.4±56.63 min, 35.58±4.43 min and 60.58±4.43 min, respectively. Ejection fraction and end systolic volume in patients with ST-segment resolution greater than 30% at 60min, 90min, 120min and 24 h after PCI were significantly higher than that in patients with resolution lower than 30%. This finding was not observed 2 months after PCI. Conclusion: While delays in managing patients with STEMI had favorable outcomes in our center in contrast to similar studies, attempts should be made to reduce these delays. STSR greater than 30% at 90min and 120min after successful PCI in patients with STEMI is significantly related with higher ejection fractions and lower end-systolic volumes. However, if the STSR occurs after 24 hours, then these patients are more likely to have lower ejection fractionsand larger end-systolic volumes.