급성 심근경색환자에서 재관류 후 운동부하 심전도에서 T파의 정상화 소견과 심근기능 회복과의 관계

초록

Background: Several studies has been reported that T-wave normalization (TWN) in exercise ECG indicates the presence of viable myocardium. But the clinical implication of this phenomenon in patients with acute myocardial infarction who received proper revascularization therapy was not determined. The aim of this study was to investigate the relationship between TWN in exercise ECG and myocardial functional recovery after acute myocardial infarction. Methods: We studied 30 acute myocardial infarction patients with negative T waves in infarct-related electrocardiographic leads and who received successful revascularization therapy. All patients performed exercise ECG, 10–14 days after infarct onset using Naughton protocol. Patients were divided into 2 groups, according to presence (group I; n=14) or not (group II; n=16) of TWN in exercise ECG. Exercise parameters, coronary angiographic findings were compared between groups. Baseline and follow-up (mean 11 months) regional and global left ventricular function was analyzed by echocardiography. Results: Exercise parameters was similar between groups. There were no difference in baseline ejection fraction and regional wall motion between group I and II (EF; 56±12% vs 52±11%, p=ns. WMS; 21±3 vs 23±4, p=ns) and it was improved at the tenth month by similar magnitude (group I/group II, EF % change = 12±12% vs 7±6%, p=ns, WMS % change = 6±6% vs 7±5%, p=ns). The findings of no relation between TWN and functional recovery was observed also when the patients were analysed according to infarct location and presence of Q-waves. Conclusion: As the exercise-induced TWN in patients with acute myocardial infarction was not related with better functional recovery of dysfunctional regional wall motion, TWN dose not appears to be a sign of myocardial viability.

키워드