Abstract
Background and Objectives:The restoration of infarct-related coronary artery (IRA patency in acute myocar- dial infarction (AMI linked to a significant improvement in survival. Because of microvascular and cellular injury, patent IRA does not always represent successful reperfusion. With progress of myocardial ischemia, standard 12 lead ECG shows evolutional changes of ST-segment, R wave and Q wave. But their relations to my- ocardial perfusion were uncertain. Methods:Total 41 patients of the first anterior wall AMI were enrolled and serial ECGs were taken to measure sum of ST-segment elevation (∑ST, sum of Q wave (∑Q, sum of R wave (∑R, and QRS score (QRSs proposed by Selvester in each patients before thrombolytic therapy (i, after co- ronary angiography at 90 minutes of thrombolytic therapy (a, and before discharge (d. Myocardial contrast echocardiography was performed within 10 days of AMI to estimate opacification score (OS and opacification index (OI in segments of LAD territory. We investigate the relation between evolution of ECG changes and perfusion status of infarcted myocardium. Results:1 There was no relation between OI and ∑ST, but ∑R and QRSs showed significant relation with OI before discharge (r=0.59, -0.33, p<0.05, respectively, post throm- bolytic therapy (r=0.51, -0.61, p<0.05, and baseline ECG (r=0.53, -0.51, p<0.05. 2 The number of segments with OS (0.5 showed no singificant relation to the degree of ∑ST and ∑Q, but number of segments with OS (0 showed singinficant relation to that of ∑R and QRSs (r of ∑Ri, ∑Ra, ∑Rd vs number of segments with OS (0=-0.59, -0.66, -0.43, p<0.05, QRSi, QRSa, QRSd vs number of segments with OS (0=0.58, 0.58, 0.57, p<0.05. Conclusion:These findings suggest that the ECG changes of R wave and QRS scores could be useful markers of perfusion state in thrombolytic era. (Korean Circulation J 1998;28(10 :1707-1716
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