Document Detail


"Mirror-lake" serial relationship of electrocardiographic and biochemical indices for the detection of reperfusion and the prediction of salvage in patients with acute myocardial infarction.
MedLine Citation:
PMID:  14597923     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Serial observations of biochemical markers in the blood and bioelectric markers on the electrocardiogram (ECG) have been used to evaluate the effectiveness of reperfusion therapy in acute myocardial infarction (AMI). This study presents a combined method for clinical use, based on the "mirror-lake" tendency of the serial changes in these markers. METHODS: Consecutive thrombolytic-treated patients with AMI (n = 43) had ST-segment monitoring (Mortara Eli 100) and frequent serum sampling of myoglobin (MG) concentration. Their acutely predicted and finally estimated AMI sizes and myocardial salvage extents were calculated from the 12-lead standard ECG. Patients having 2 positive reperfusion indices (ST resolution at least 50%, and an increase in MG at least 2.4 fold) at 2 hours after initiation of thrombolytic therapy were considered the "complete reperfusion" group, and patients with discordant or 2 negative reperfusion indices after 2 hours of thrombolytic therapy were considered the "limited reperfusion" group. RESULTS: Patients with complete reperfusion (n = 22) versus patients with limited reperfusion (n = 21) had +12% versus -1% myocardial salvage (P <.0001). The serial changes in the ST segment mirrored the serial changes in the MG concentration, and the rates of increase in MG correlated with the rates of resolution of the ST-segment elevation. CONCLUSION: Myocardial salvage (measured by ECG indices) is greatest when an early increase in serum MG is "mirrored" by early resolution of ST-segment elevation.
Authors:
Birgit Jurlander; Lene Holmvang; Søren Galatius; Creighton Vaught; Per Johanson; Mitchell W Krucoff; Peer Grande; Peter Clemmensen; Galen S Wagner
Related Documents :
17320223 - Pneumomediastinum mimicking acute st-segment elevation myocardial infarction.
19068143 - Ultrasound enhanced prehospital thrombolysis using microbubbles infusion in patients wi...
1269093 - Mitochondrial structure and function in acute myocardial ischemic injury.
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  146     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-04     Completed Date:  2004-02-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  757-63     Citation Subset:  AIM; IM    
Affiliation:
The Heart Center, Copenhagen University Hospital, Rigshospitalet, and Hillerød, Sygehus, Copenhagen, Denmark.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Coronary Circulation
Creatine Kinase
Electrocardiography*
Female
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*,  physiopathology,  therapy*
Myocardial Reperfusion*
Myoglobin / blood
Salvage Therapy*
Thrombolytic Therapy
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Myoglobin; EC 2.7.3.2/Creatine Kinase
Comments/Corrections
Comment In:
Am Heart J. 2003 Nov;146(5):747-9   [PMID:  14597920 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  DHA-rich phospholipids optimize G-Protein-coupled signaling.
Next Document:  Optimizing glycoprotein IIb/IIIa receptor antagonist use for the non-ST-segment elevation acute coro...