Document Detail


Diagnosis and discrimination of remote antero- and inferoseptal non-Q wave myocardial infarctions with body surface potential mapping.
MedLine Citation:
PMID:  18209770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have shown that the diagnosis and localization of previous non-Q wave myocardial infarction (NQMI) is possible by body surface potential mapping (BSPM), but the criteria for the discrimination between anteroseptal and inferoseptal middle regions remain to be determined. METHODS: BSPM using 63 unipolar leads was recorded in 119 patients with previous NQMI (36 to 76 years of age, average 61 years; 85 men). Localization of anteroseptal or inferior middle NQMI occurred in 70 cases (44 to 76 years of age, average 61 years, 53 men) by determining early anterior minimum potential with only slight negativity. In these cases, isopotential maps obtained at additional time points were investigated to discriminate between anteroseptal and inferoseptal NQMI. The clinical localization was based on the concordance of two of the following tests: wall motion disturbances on echocardiography, coronary angiogram and repolarization changes in the acute-phase electrocardiogram. RESULTS: Two milliseconds before the appearance of the first anterior minimum, a more accentuated superior negativity indicated anteroseptal NQMI (32 of 70 cases), while a more pronounced inferior negativity indicated inferoseptal NQMI (38 of 70 cases). Fisher's exact test showed statistically significant associations between the above BSPM localizations and the clinical localizations (P<0.001). Occlusion or stenosis of the expected infarct-related coronary artery was detected in all patients either as a single lesion or together with other coronary artery lesions. CONCLUSIONS: The BSPM criteria proposed here are suitable to detect the most frequent NQMI localizations. The narrowing of the infarct-related coronary arteries, the left anterior descending or the posterior descending coronary artery, can be thus differentiated.
Authors:
Mihály Medvegy; Réginald Nadeau; Endre Szücs; Krisztina Szakolczai; Gábor Simonyi; Tamás Bauernfeind; Miklos Szedlák; Pierre Savard; Donald Palisaitis; István Préda
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  24     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-22     Completed Date:  2008-03-19     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  53-5     Citation Subset:  IM    
Affiliation:
Central Hospital of Ministry of Interior, Cardiology, Budapest, Hungary.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Surface Potential Mapping*
Electrocardiography*
Female
Heart Conduction System
Humans
Male
Middle Aged
Monitoring, Ambulatory
Myocardial Infarction / diagnosis*,  physiopathology*
Predictive Value of Tests
Sensitivity and Specificity
Comments/Corrections

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


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