Karadede A.A.Temamo?ullari A.V.Aydinalp Ö.Ülgen M.S.Alan S.Iltümür K.Toprak N.2024-04-242024-04-2420011016-5169https://hdl.handle.net/11468/24094Although a relation between magnitude of ST segment elevation and myocardial damage was shown in early period of acute myocardial infarction, such a relation among shape of the ST segment elevation, myocardial damage and clinical course remains obscure. Sixty-two patients with acute anterior MI, in the first six hours of their first heart attack were enrolled for the study. Based on the precordial V3 derivation prior to thrombolytic treatment, the shape of the ST elevation was separated into three groups as concave (n=26), straight (n=24) or convex types (n= 12). The relation between the shape of the elevation recorded on admission and both results of low dose (5 and 10 ?g/kg/min) dobutamine stress echocardiography (LDSE) performed (n=53) in early period (the sixth day) of infarction and clinical course were investigated. Wall Motion Score Index (WMSI) was evaluated based on a 16-segmented scoring system of which nine segments were supplied by left anterior descending artery (LAD) and points were given for each segment from one (normal) to four (dyskinetic). Basal WMSI and response to LDSE were better in LAD region. Additionally both average akinetic segment number in infarct zone was higher and improvement in these segments were less in convex and straight groups (Concave 3,78±2 vs. 2,17±2.1 p<0.01; straight 5,15±2.7vs. 4,45±2,8, NS; convex 5,4±2,3 vs. 4,8±2,1 NS; basal vs. LDSE). Although only 13% (3/23) of the patients had no improvement in LDSE in Group A (p<0.05 v.s. group B and p<0.01 v.s. group C), 35% (7/20) of group B and 60% (6/10) of Group C patients were without improvement in LDSE. Although no relation was found between better left ventricular function (WMSI <2) and shape of the ST elevation in basal evaluation in multiple logistic regression analysis (p=0.06), an independent relation was found following LDSE (p=0.01, OR 4.5, %95CI 1.3-14.7). There was no in-hospital death in concave group whereas five patients died in either straight or convex group. Arrhythmia occurrence was lower in concave group during this period (p<0.05), and exercise capacities were lower. Conclusively, we suggested that there was an increased viability in infarct zone and decreased in-hospital mortality in patients with concave ST elevation on admission. This simple classification would be beneficial to estimate left ventricular functions at discharge.trinfo:eu-repo/semantics/closedAccessDobutamine EchocardiographyMyocardial İnfarction St ElevationArticle2928592+692-s2.0-0035110729Q3