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DO LATE POTENTIALS RECORDED IN THE SUBACUTE PHASE OF MYOCARDIAL INFARCTION PREDICT LEFT VENTRICULAR REMODELLING - 1 YEAR FOLLOW-UP.
Authors: M.Grygier, W.Skorupski, T.Mularek-Kubzdela, J.Kowal, T.Podżerek, M.Prech, A.Targońska, M.Popiel, S.Grajek, A.Ciesliński
From: Cardiology Department, University School of Medical Sciences, Poznań
Background: Infarct expansion and ventricular remodeling are important determinants of ventricular function after myocardial infarction. There are similarities between the histological changes underlying infarct expansion and those believed to underlie slow conduction and arrhythmogenesis.
Aim: A prospective study was undertaken to assess the possible relation between late potentials recorded in the subacute phase of myocardial and left ventricular volumes and ejection fraction changes during 1-year follow-up after myocardial infarction.
Methods: The study group consisted of 67 consecutive patients with acute myocardial infarction, who received thrombolytic treatment. Signal-averaged ECGs were recorded on day 3, 7 and 14 using conventional time domain parameters. Ventricular volumes and ejection fraction were assessed echocardiographically on day 3, after 3 and 6 months, and 1 year from index infarction and end-diastolic, end-systolic volume indexes and ejection fraction were calculated.
Results: Patients with persistent late potentials on all three recordings (n=12) showed a progressive, significant (p<0.05) increase in end-diastolic volume index during the first 6-month of follow-up and a lack of improvement in ejection fraction in 1-year follow-up. Patients without late potentials on all three recordings (n=48) showed a statistically significant (p<0.01) increase in ejection fraction and not significant changes in end-diastolic and end-systolic volume indexes during 1-year observation. Patients demonstrating dynamic positivity of late potentials (n=7) showed also a statistically significant (p<0.01) increase in ejection fraction and not significant changes in end-diastolic and end-systolic volume indexes during 1 -year follow-up.
Conclusion: It is concluded that persistent late potentials recorded in the subacute phase of myocardial infarction seems to be associated with subsequent left ventricular remodelling. It is possible that these early-phase late potentials may serve as a predictor of subsequent ventricular dilatation.




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