Prognostic usefulness of dobutamine-induced ST-segment elevation and T-wave normalization after uncomplicated acute myocardial infarction

Risk stratification of patients after an uncomplicated acute myocardial inf arction (AMI) with normal left ventricular function mainly relies on the pr esence of viable jeopardized myocardium within the infarct area. Both myoca rdial ischemia and viability have indicated a higher cardiac risk in these patients,(1-3) findings that have been further emphasized in the post-throm bolytic era. Dobutamine stress echocardiography (DSE), an established imagi ng technique, may be enhanced by an appriopriate interpretation of the surf ace electrocardiogram (ECG). Both ST-segment elevation and T-wave normaliza tion (TWN) have been correlated with myocardial viability and ischemia.(4,5 ) We addressed the prognostic impact of dobutamine-induced ST-segment eleva tion and TWN in a prospective, observational study.