Abstract

BACKGROUND
Transmyocardial ischemia is manifested as ST-segment elevation (STE). We examined acoustic cardiographic indices of STE that occur during percutaneous coronary intervention (PCI).
METHODS
Of 83 patients undergoing coronary angiography, 25 underwent PCI, including 5 who developed STE. Continuous 12-lead ECG and computerized acoustic cardiographic heart sound analysis were performed during PCI. Intensities of the heart sounds (S1 to S4), diastolic time (from S2 to S1), and systolic time intervals (S1 to S2) were recorded.
RESULTS
As STE increased, there was no change in heart rate or systolic time. Contractility decreased, with an increase in S3 intensity and a reduction in S1/S2 ratio. Left ventricular stiffness increased, reflected by an increase in S4 intensity.
CONCLUSIONS
As transmyocardial ischemia worsened during progressive STE, acoustic cardiographic indices reflected impaired contractility and increased ventricular stiffness. In particular, the S4 was most predictive of increasing degrees of STE. These findings have implications for assessment of transmyocardial ischemia in patients with ECG findings that confound ST segment interpretation.

Links

Publisher Full Text

Authors

Karebsheh S, Michaels AD

Institution

Division of Cardiology, University of Utah, Salt Lake City, USA.

Source

Acute cardiac care 13:1 2011 Mar pg 3-8

MeSH

Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Cohort Studies
Coronary Angiography
Echocardiography
Female
Heart Auscultation
Heart Sounds
Humans
Male
Middle Aged
Myocardial Ischemia
Prospective Studies

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21244232