ABRUPT AUGMENTATION OF ST SEGMENT ELEVATION ASSOCIATED WITH SUCCESSFUL REPERFUSION - A SIGN OF DIMINISHED MYOCARDIAL SALVAGE

To investigate the significance of abrupt augmentation of ST segment e levation immediately after reperfusion, 36 patients with an initial ac ute anterior myocardial infarction successfully treated with thromboly sis were studied. Immediately after reperfusion was performed, 17 (47% ) patients showed abrupt augmentation of ST segment elevation of anter ior area (E group), and 19 (53%) patients did not (N group). The time to reperfusion was not significantly different between the two groups. In the E group the peak level of creatine kinase MB isozyme was highe r (p < 0.05) than in the N group. The left ventricular ejection fracti on (EF) did not increase in the E group from acute to chronic phase. H owever, in the N group EF increased significantly. The difference in E F in the chronic phase was significant between the two groups (p < 0.0 5). The infarcted regional wall motion (RWM) did not increase in the E group, whereas in the N group it increased markedly (p < 0.05). In ad dition, the infarcted RWM in the chronic phase was worse in the E grou p than in the N group (p < 0.05). Abrupt augmentation of ST segment el evation associated with successful reperfusion appears to reflect dimi nished myocardial salvage.