Document Detail

Measurement of S-T segment elevation in acute myocardial infarction in man. Comparison of a precordial mapping technique and the Frank vector system.
MedLine Citation:
PMID:  1155336     Owner:  NLM     Status:  MEDLINE    
Precordial S-T segment mapping has been used to evaluate the extent of ischemic injury in patients with acute myocardial infarction. Because precordial S-T segment mapping is time-consuming and is limited to patients with anterior wall myocardial infarction, we evaluated the possibility of using the magnitude (ST-VM) and direction (ST-VD) of the S-T vector, derived from X, Y and Z leads of the Frank vector system, as a substitute for the precordial S-T segment mapping technique. Precordial S-T segment mapping and Frank system vectorcardiograms were simultaneously obtained in three groups: (1) nine normal subjects; (2) nine patients with persistent S-T segment elevation 2 to 15 months after acute anterior myocardial infarction; and (3) nine patients with acute anterior myocardial infarction studied on 41 occasions. For both systems the S-T segments were analyzed 20 and 60 msec after completion of inscription of the QRS complex. The sum of the S-T segment elevations for the 35 sites (sigma ST) and the number of sites (NST) in which S-T segment elevations exceeded 0.1 mv were computed for the precordial S-T maps. The ST-VM and ST-VD were calculated by standard formulas from X, Y and Z lead tracings of the Frank vector system. Good correlations were observed between: ST-VM and sigma ST (r = +0.818 and +0.791 at 20 and 60 msec, respectively, P less than 0.001); and ST-VM and NST (r = +0.773 and +0.705 at 20 and 60 msec, respectively, P less than 0.001). Furthermore, changes in the location of S-T segment elevations in serial precordial S-T segment maps were reflected by changes in ST-VD. Observations in patients with inferior wall myocardial infarction suggest that ST-VM and ST-VD can be serially followed in such patients. Thus, estimation of the magnitude and direction of the S-T vector is a simple alternative to standard precordial S-T segment mapping that allows for continuous monitoring of S-T segment elevations in all patients with acute myocardial infarction.
T Akiyama; M Hodges; T L Biddle; B Zawrotny; C Vangellow
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  36     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1975 Aug 
Date Detail:
Created Date:  1975-11-06     Completed Date:  1975-11-06     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:  155-62     Citation Subset:  AIM; IM    
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MeSH Terms
Acute Disease
Cardiac Volume
Coronary Disease / physiopathology
Heart Conduction System / physiopathology
Middle Aged
Myocardial Contraction
Myocardial Infarction / diagnosis*,  physiopathology
Vectorcardiography / methods*

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