| PrefaceOne of the most effective treatments for acute myocardial infarction (AMI) patients is the early myocardial revascularization. So it will instruct the clinical therapy greatly to investigate and estimate the relationship between the sign of reperfusion after PCI and the prognosis of the acute myocardial infarction. The index of the reperfusion after PCI has been widely studied worldwide, and electrocardiograph changes have been regarded as one of the index of IRA. Nowadays, the relationship between the electrocardiograph changes after PCI and the prognosis in the ST elevated acute myocardial infarction is still an open topic in China. Clinically, more and more patients can afford the PCI, and direct PCI will accelerate the transformation of ST segment and T wave. Our research is to clarify the relationship between the ST segment recovery & early T wave inversion and the left ventricular function.ObjectiveTo investigate the relationship between ST segment, T wave and Left Ventricular functional after PCI in patients with acute anterior myocardial infarction. MethodFrom Jan 2005- Jan 2006, 60 anterior AMI patients with elevated ST segment were surveyed and studied after successful primary PCI for 6 months. Indication: (1) persistent chest pain exists for more than 30 min, and nitrate esters fails to be effective. (2) Chest pain exists for less than 12 hr before get treated, but becomes acute between 12 -24 hr with obvious elevation of ST segment. (3) Two or more adjacent ST segments are elevated for over 0.2 mV. During following-up, anticoagulants, adrenergicβ-blockade, ACEI, and nitrate esters were prescribed as regular treatments. The exclusion criteria includes: acute disease in liver and kidney, left main coronary artery disease, factors that changes the ST segment including complete left bundle branch block (RLBBB), wolff-parkinson-white syndrome, and pacing electrocardiograph, etc. Electrocardiograms are applied before and after 1 hr of the PCI, and within 24 hr of PCI. ST segment is measured from 0.04 s after J point to the beginning of T wave, and from top of baseline to the top of ST segment (The extension of T-P segment is applied as the baseline). ST segment recovery is estimated as the percentage of the decrease of ST segment at 24 hours after operation in the total elevated ST segment. Negative homogeneous phase T wave is regarded as inversed T wave if the amplitude exceeds 0.1 mV. Following PCI, ST segment elevation≥50% from baseline was documented in 40 patients but not in 20. After AMI 24 hours, only T wave inversions were documented in 42 but not in 18. All patients had a successful PCI and underwent 3Dechocardiography and Doppler tissue imaging (DTI) soon after PCI at1 and 6 months later. Echocardiogram: Philips iE33 ( USA) with probe x3-1, frequency 1-3 MHZ is used for measurement. Patients lies in left lateral position, Results: There are significant different in LVEF, Em/Am at 1 month and 6 month after PCI (P<0.05) in two groups. There are significant different in LVD at six moths after PCI (P<0.05) But not in one moths (P>0.05) . ConclusionST segment recovery and T wave early inversion on ECG after primary PCI can assess recovery of left ventricular dysfunctional.
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