Document Detail


The relationship between initial ST-segment deviation and final QRS complex changes related to the posterolateral wall in acute inferior myocardial infarction.
MedLine Citation:
PMID:  21871997     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to assess the relationship between initial ST-segment deviation and final QRS complex changes related to the posterolateral left ventricular wall in patients with acute inferior myocardial infarction receiving reperfusion therapy. The secondary aim was to determine if this relationship is stronger for patients who present early in the ischemia/infarction process in comparison with patients who present late.
METHODS: The ST-segment depression in the leads V(1), V2, and -V6 were measured in the electrocardiograph (ECG) just before initiation of myocardial reperfusion. These leads were chosen because they represent the posterolateral wall in the Selvester score. In addition, the Anderson-Wilkins acuteness score was calculated in the admission ECG. Selvester criteria related to the posterolateral wall were identified in the ECG performed before hospital discharge to assess final infarct size.
RESULTS: Fifty-six patients were included in this study. No significant relationship was found between the sum of initial ST-segment depression in the leads V(1), V(2), and -V(6), and final infarct size in the posterolateral left ventricular wall for the total study population (r = 0.19, P = .16). Patients were subgrouped by Anderson-Wilkins acuteness score of less than 3 vs 3 or more. In those with a low acuteness score, the amount of ST-segment depression had no relationship with final infarct size (r = -0.16, P = .41). However, the correlation was statistically significant for those with a high acuteness score (r = 0.42, P = .04).
CONCLUSION: The initial ST-segment depression in leads V(1), V(2), and -V(6) can predict ECG-estimated amount of infarction in the posterolateral left ventricular wall in patients with acute inferior myocardial infarction receiving reperfusion therapy, but only in those who present early in the ischemia/infarction process.
Authors:
Sjoerd Bouwmeester; Irene E G van Hellemond; Charles Maynard; Sebastiaan C A M Bekkers; Kirian van der Weg; Galen S Wagner; Anton P M Gorgels
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  44     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-08-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  509-15     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, University Hospital Maastricht, Maastricht, The Netherlands; Duke University Medical Center, Durham, NC, USA.
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