The Clinical Meaning Of Early T Wave Inversion After Thrombolytic Therapy In Acute Myocardial Infarction Patients

Background：The early myocardial revascularization is necessary for acute myocardial infarction(AMI) patients. So it will instruct the clinical therapy greatly to investigate andestimate the relationship between the sign of reperfusion after intravenousthrombolysis and the prognosis of the acute myocardial infarction.The index of thereperfusion after intravenous thrombolysis has been widely studied worldwide,andelectrocardiograph changes have been regarded as one of the index of IRA. There aremany evaluation methods to the reperfusion on patients with acute myocardialinfarction after thrombolytic therapy in clinical, but little attention to the changes in Twave. This study is to further clarify the evaluation and prediction of early T waveinversion in reperfusion.Objective：To observe the dynamic changes of electrocardiogram ST-T in acute ST segmentelevation myocardial infarction (STEMI) after intravenous thrombolytic therapy; Toinvestigate the relationship between early (within24hours) T wave inversion andrecanalization of the infarct-related artery and prognosis.Methods：From2010April to2011December,84AMI patients with acute ST segmentelevation hospitalized in internal medicine-cardiovascular department of QuanzhouFirst Hospital affiliated to Fujian Medical University Department, diagnosis of the2007American College of Cardiology (ACC)/American Heart Associationstandards.According to the T wave changes of84patients treated with intravenousthrombolysis within24hours, divided into T wave inversion group and no T waveinversion group, to compare the T wave inversion group’s recanalization rate with theother group’s according to the late coronary angiography. At the same timedynamically observe the changes of ST segment of electrocardiogram, myocardialenzymes, analyze the relationship with T wave inversion. To observe the incidence ofvascular events (cardiac death, hospitalized causes of cardiovascular disease,recurrence of angina pectoris, heart failure)of the selected patients within3months; To compare left ventricular ejection fraction (LVEF), left ventricular end diastolicdiameter (LVEDd) of two groups.Results：There is higher coronary artery recanalization rate in early T wave inversion groupafter thrombolytic therapy, and a strong correlation between them. Early T waveinversion group is accompanied by the fall of electrocardiographic ST segment, theadvancement of myocardial enzyme peak. There are lower（34.4%） cardiovascularevent rates and higher left ventricular ejection fraction in early T wave inversiongroup within3months.Conclusions：After acute ST segment elevation myocardial infarction patients treated withintravenous thrombolysis, early T wave inversion indicates the recanalization of theinfarct-related artery, and is highly consistent with the fall of electrocardiographic STand the advancement of myocardial enzyme peak. The patients with early T waveinversion after thrombolysis who are dianosed with acute ST segment elevationmyocardial infarction have lower near future cardiovascular event rates and better leftventricular function recovery.