ST segment reelevation occurs naturally in the days following acute anterior MI and correlates with infarct size, highlighting the importance of timing when using ST segment changes to evaluate therapeutic interventions.
Natural ST reelevation post-anterior MI may confound early assessments; hypothesis-generating for timing standardization in future intervention trials.
Serial recordings of ST segment mapping were performed in 15 patients with acute anterior myocardial infarction. Reelevation of ST segment was observed in all cases between 12 hours and one week after infarction without clinical evidence of reinfarction. There was significant correlation between the magnitude of the sum of ST reelevation (sigma ST) and time to the peak of ST reelevation. The higher was sigma ST at the peak, the later was the appearance of the peak of ST reelevation. sigma ST recorded between 24 and 72 hours after infarction correlated with the extent of abnormal Q (NQ) in the precordial mapping as well as the percent of abnormally contracting segment (%ACS) on left ventricular angiography examined after 4 weeks following infarction. However, there was no correlation between sigma ST recorded at 12 hours after infarction and NQ studied at 4 weeks after infarction. The results indicate that the magnitude of sigma ST changes in time during the course after infarction and that the time of recording is important when sigma ST is used for the estimation of infant size. Reelevation of ST segment should be considered in the study of therapeutic intervention in acute myocardial infarction.
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Nakagaki et al. (1981) studied this question.
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