Key result
Greater ST-segment elevation (≥0.2 mV) during balloon inflation was associated with a significantly greater and more prolonged reduction in regional work performance of the ischemic interventricular septum.
Why the study?
Does the degree of ST-segment elevation during coronary angioplasty correlate with the reduction and recovery of left ventricular regional work in patients with proximal LAD stenosis?
Observational (n=25)
No
Does the degree of ST-segment elevation during coronary angioplasty correlate with the reduction and recovery of left ventricular regional work in patients with proximal LAD stenosis?
Absolute Event Rate: 0.5% vs 2%
p-value: p=<0.05
Greater ST-segment elevation during transient ischemia from coronary angioplasty is associated with a more profound and prolonged reduction in regional left ventricular work.
May reflect more severe ischemic injury during angioplasty; hypothesis-generating and requires prospective validation before clinical adoption.
This study evaluated the reduction in regional work of the left ventricle caused by acute myocardial ischemia during coronary angioplasty, and correlated it with ST-segment elevation. Regional work of the left ventricular myocardium, which is derived from a stress-strain loop, is a useful index of the function of a diseased heart. However, the effects of transient ischemia on the regional work of the myocardium have not been fully elucidated. The subjects consisted of 25 patients who had proximal left anterior descending artery stenosis with normal wall motion and without collateral circulation. The patients were classified as showing ST-segment elevation > or = 0.2 mV (group A, 10 patients), or ST-segment elevation < 0.2mV (group B, 15 patients) during coronary angioplasty. Group A showed a greater reduction in the regional work of the interventricular septum than group B. Regional work recovered to the baseline level 30 s after balloon deflation in group B, but took 40 s in group A. A greater ST elevation during balloon inflation was associated with a greater, prolonged reduction of work performance in the ischemic region and a greater concomitant increase in the opposite nonischemic region.
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Isobe et al. (2001) conducted an observational in Stable angina pectoris with proximal LAD stenosis (n=25). ST-segment elevation ≥0.2 mV during PTCA vs. ST-segment elevation <0.2 mV was evaluated on Regional work of the interventricular septum at the end of 60 seconds of balloon inflation (p=<0.05). Greater ST-segment elevation (≥0.2 mV) during balloon inflation was associated with a significantly greater and more prolonged reduction in regional work performance of the ischemic interventricular septum.
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