The Relation Between ST Segment Elevation Shape and Low Dose Dobutamine Stress Echocardiography and Clinical Course in Early Period of Anterior Myocardial Infarction

Although a relat ion 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 elinical 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 derİvation prior to thrombolytic treatment, the shape of the ST e levation 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 ı.ıg/kg/min) dobutamine stress echocardiography (LDSE) performed (n=53) in early period (the sixth day) of infaretion and elinical 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). Basa! 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; basa! 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 pKeywords: Dobutamine echocardiography, myocardial infarction, ST elevation