Document Detail


Relationship between the site of a myocardial infarction and signal-averaged electrocardiogram indices.
MedLine Citation:
PMID:  9510486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated the relationship between the site of a myocardial infarction (MI) and signal-averaged electrocardiogram (SAECG) indices in both time-domain (TDA) and spectral turbulence (STA) analyses, and their implications in the prediction of infarct-related artery (IRA) patency, in 114 survivors of a first MI. They were divided into two groups based on MI location (57 anterior and 57 inferior). Patients with bundle branch block were not included. Fifty patients had been treated with thrombolytic therapy (TT). The STA was done in both XYZ-leads and in vector magnitude. Forty patients had an abnormal SAECG in TDA and 37 in STA, but only 22 (19%) in both (71% of agreement, kappa=0.35). Fifty-four patients (47%) had an occluded IRA. The best predictors from multivariate analysis of having an occluded IRA in the inferior MI group were: an abnormal Y-lead in STA (odds ratio 4.9; P=0.005); an abnormal RMS40 in TDA (odds ratio, 4.8; P=0.02); absence of TT (odds ratio, 9.15; P=0.001). Conversely, in the anterior MI group they were: an abnormal SAECG in TDA (odds ratio 6.83; P=0.005); absence of TT (odds ratio, 4.3; P=0.02). The multivariate receiver operator characteristic curves clearly showed the effect of MI location on the SAECG indices. This study suggests that the myocardial infarction site is an important factor for the variability and poor concordance between TDA and STA. Such differences may alter the predictive accuracy of SAECG. TDA and STA should be complementary methods, and the exploration in each orthogonal lead appears to be better than in vector magnitude.
Authors:
M Rosas; A G Hermosillo; O Infante; J Kuri; M Cardenas
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  63     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-05-19     Completed Date:  1998-05-19     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  129-40     Citation Subset:  IM    
Affiliation:
Department of Electrocardiography and Electrophysiology, Instituto Nacional de Cardiología, Ignacio Chávez, Talplan, México City, DF, México.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Coronary Angiography
Electrocardiography / methods*
Female
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction / diagnosis*,  pathology,  physiopathology
Predictive Value of Tests
Probability
Sensitivity and Specificity
Signal Processing, Computer-Assisted
Vascular Patency

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


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