2018 Plosone (VINTAGE study)

Assessing the efficacy of revascularization therapy in patients with ST-segment elevation
myocardial infarction (STEMI) is extremely important in order to guide subsequent management
and assess prognosis. We aimed to determine the relationship between corrected QTinterval
(QTc) changes on standard sequential ECG and myocardial salvage index in anterior
STEMI patients after successful primary percutaneous coronary intervention. Fifty anterior
STEMI patients treated by primary percutaneous coronary intervention underwent
quantitative ECG analysis and cardiac magnetic resonance. For each patient the difference
(ΔQTc) between the QTc of ischemic myocardium (maximum QTc in anterior leads) versus
remote myocardium (minimum QTc in inferior leads) during the first six days after STEMI
was measured. The QTc in anterior leads was significantly longer than QTc in inferior leads
(p<0.0001). At multivariate analysis, ΔQTC and peak troponin I were the only independent
predictors for late gadolium enhancement while ΔQTc and left ventricular ejection fraction
were independent predictors of myocardial salvage index <60%. The receiver operative
curve of ΔQTc showed an area under the curve of 0.77 to predict a myocardial salvage
index <0.6. In conclusion, in a subset of patients with a first occurrence of early revascularized
anterior STEMI, ΔQTc is inversely correlated with CMR-derived myocardial salvage
index and may represent a useful parameter for assessing efficacy of reperfusion therapy