Circulation, Vol 88, 905-914, Copyright © 1993 by American Heart Association
AG Zaman, JL Morris, JH Smyllie and JC Cowan
BACKGROUND. Arrhythmias are common in patients who have developed
ventricular enlargement after myocardial infarction. METHODS AND RESULTS. A
prospective study was undertaken to assess the relation between ventricular
dilatation and the development of late potentials after myocardial
infarction. Echocardiograms and signal-averaged ECGs were recorded on days
1,3,7, and 42 in 52 patients with a first anterior myocardial infarction.
Twenty-nine percent of patients were late potential-positive on their
initial signal-averaged ECG recorded on the day of admission. The incidence
of late potentials rose during the next week to a peak of 42% at day 7,
declining to 13% by day 42. The presence of late potentials on the day of
admission was associated with an increase in end-diastolic volume index of
16.1 +/- 6.0 mL/m2 (mean +/- SEM), compared with a decreased of 4.7 +/- 2.7
mL/m2 among late potential-negative patients (P < .006). Qualitatively
similar results were evident for late potentials on day 3 and day 7. By
contrast, there was no association between late potentials on day 42 and
ventricular dilatation. Marked dynamic changes in late potentials were
evident during the first week. Patients with persistent late potentials (n
= 9) on all three recordings in the first week showed a marked increase in
end-diastolic volume index of 21.3 +/- 8.1 mL/m2 (P < .005 in comparison
with patients who were persistently negative [n = 20]). Patients
demonstrating dynamic positivity (n = 15) not present on all three
recordings in the first week showed no significant increase in
end-diastolic volume index. CONCLUSION. It is concluded that late
potentials during the first week after infarction are associated with
subsequent ventricular dilatation. These early-phase late potentials may be
a manifestation of cell slippage. They arise before gross topographical
enlargement and may serve as a predictor of ventricular dilatation.
ARTICLES
Late potentials and ventricular enlargement after myocardial infarction. A new role for high-resolution electrocardiography?
Department of Cardiology, General Infirmary, Leeds, UK.
This article has been cited by other articles:
 |
|
 |
|
  S. J. McClure, S. Gall, C. B. Schechter, M. Kearney, and A. G. Zaman Percutaneous Coronary Revascularization Reduces Plasma N-Terminal Pro-B-Type Natriuretic Peptide Concentration in Stable Coronary Artery Disease J. Am. Coll. Cardiol., June 26, 2007; 49(25): 2394 - 2397. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Narayan and J. M. Smith Exploiting rate-related hysteresis in repolarization alternans to improve risk stratification for ventricular tachycardia J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1485 - 1492. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Narayan, B. D. Lindsay, and J. M. Smith Demonstration of the Proarrhythmic Preconditioning of Single Premature Extrastimuli by Use of the Magnitude, Phase, and Distribution of Repolarization Alternans Circulation, November 2, 1999; 100(18): 1887 - 1893. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. N. Neskovic, A. Mojsilovic, T. Jovanovic, J. Vasiljevic, M. Popovic, J. Marinkovic, M. Bojic, and A. D. Popovic Myocardial Tissue Characterization After Acute Myocardial Infarction With Wavelet Image Decomposition : A Novel Approach for the Detection of Myocardial Viability in the Early Postinfarction Period Circulation, August 18, 1998; 98(7): 634 - 641. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Savard, J.-L. Rouleau, J. Ferguson, N. Poitras, P. Morel, R. F. Davies, D. J. Stewart, M. Talajic, M. Gardner, R. Dupuis, et al. Risk Stratification After Myocardial Infarction Using Signal-Averaged Electrocardiographic Criteria Adjusted for Sex, Age, and Myocardial Infarction Location Circulation, July 1, 1997; 96(1): 202 - 213. [Abstract] [Full Text]
|
|