Document Detail


Comparison of patients with anterior wall healed myocardial infarction with and without exercise-induced ST-segment elevation.
MedLine Citation:
PMID:  9462598     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess the extent of myocardial necrosis and ischemia in patients with anterior wall healed myocardial infarction depending on whether ST-segment elevation was present on precordial leads during exercise testing, 62 consecutive patients (49 men and 13 women, age [mean +/- SD] 56 +/- 11 years) with anterior wall infarcts were assessed with exercise technetium-99m (Tc-99m) methoxy-isobutyl-isonitrile single-photon emission computed tomography and quantification of the extent of necrosis and ischemia on polar maps: 22 patients had > or = 1 mm ST-segment elevation during exercise, and 40 did not. The extent of the necrosis in the anteroseptal (p = 0.001) and apical (p = 0.002) regions, the extent of ischemia in the lateral region (p = 0.003) on polar maps, and the frequency of ventricular aneurysm as shown by cardiac catheterization (p = 0.001) were significantly greater in patients with ST-segment elevation. In a multiple logistic regression model, both extent of necrosis in the anteroseptal region (odds ratio 10.8; 95% confidence interval 2.7 to 44.0) and extent of ischemia in the lateral region (odds ratio 7.25; 95% confidence interval 1.6 to 32.7) were associated with exercise-induced ST-segment elevation. These data suggest that ST-segment elevation in anterior infarctions is associated with wider necrosis in the anteroseptal and apical regions, with a wider extent of ischemia in the lateral region and a higher frequency of ventricular aneurysm. Consequently, it cannot be used as a marker of viability.
Authors:
J Candell-Riera; C Santana-Boado; L Armadans-Gil; P Blanch; S Aguadé; J Castell; J Vaqué-Rafart; J Soler-Soler
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  81     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-02-19     Completed Date:  1998-02-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  12-6     Citation Subset:  AIM; IM    
Affiliation:
Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Contrast Media*
Coronary Angiography
Electrocardiography* / standards
Exercise Test* / standards
Female
Heart Catheterization
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction / classification,  diagnosis*
Necrosis
Odds Ratio
Reproducibility of Results
Severity of Illness Index*
Technetium Tc 99m Sestamibi / diagnostic use*
Tomography, Emission-Computed, Single-Photon* / standards
Chemical
Reg. No./Substance:
0/Contrast Media; 109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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