Successful late coronary angioplasty of infarct-related artery suppresses ST-segment elevation on exercise, without improvement of left ventricular function

It is not clear whether the ST-segment elevation in the infarct zone during an exercise stress test is caused by expansion of the necrotic area or by ischemia. The purpose of this study was to evaluate the effects of restoring blood flow of the infarct-related coronary artery by successful coronary angioplasty in patients with silent exercise-induced ST-segment elevation in the leads corresponding to a recent (<30 days) myocardial infarction. The suppression of this ECG pattern 4 to 6 months after percutaneous transluminal coronary angioplasty (PTCA) was associated with persisting angiographic success of angioplasty, suggesting a role for ischemia in the genesis of exercise-induced ST-segment elevation. Even left-ventricular dysfunction may be a co-factor.