Relationship between spontaneous reperfusion of infarct-related arteries and T-wave inversion of corresponding leads in patients with ST-segment elevation myocardial infarction
GAO Liwei, ZHAO Jianfeng, PAN Shuanghua, HAO Yingcai, ZHU Hongtao
Abstract：Objective To explore the relationship between spontaneous reperfusion (SR) of infarct-related arteries and T-wave inversion in early ECGs of patients with acute STsegment elevation myocardial infarction (STEMI). Methods A total of 246 acute STEMI inpatients were retrospectively analyzed. The ECG within the first 6 hours of onset (the first ECG recorded by the pre-hospital emergency system or the emergency room) was taken as a criterion of determining the morphology of T-wave in an early phase. All the patients received emergency percutaneous coronary intervention. The patients’ clinical data, ECGs and angiography data were recorded in detail. According to the presence or absence of inverted T-wave in the corresponding leads of infarctrelated vessels, the enrolled subjects were divided into T-wave inversion group (33 cases) and T-wave upright group (213 cases). The incidence of SR was compared between the two groups according to the results of coronary angiography. ResultsIn the 246 patients, SR is found in infarctrelated vessels of 92 patients (37.4%); occlusion occurs in the anterior descending arteries of 120 patients (48.8%), the circumflex arteries of 28 patients (11.4%), and the right coronary arteries of 98 patients (39.8%). Among the patients with occluded anterior descending arteries, T-wave inversion is found in 23 patients (19.2%) while only 2 patients (7.1%) with circumflex artery occlusion and 8 patients (8.2%) with right coronary artery occlusion are recorded T-wave inversion in ECGs. In the STEMI patients with anterior descending artery occlusion and inverted T-wave, SR is confirmed in 19 patients (82.6%, P＜0.01) by coronary angiography; only one case (50.0%, P=0.124) of SR is found in patients with circumflex artery occlusion and inverted T-wave; 3 cases (37.5%,P=0.035) of SR are found in patients with right coronary artery occlusion and inverted T-wave. Conclusion In the ECGs of STEMI patients with anterior descending artery occlusion, early T-wave inversion in the leads with ST-segment elevation may be a predictor for SR in infarct-related arteries.
