Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging
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Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging. / Allencherril, Joseph; Fakhri, Yama; Engblom, Henrik; Heiberg, Einar; Carlsson, Marcus; Dubois-Rande, Jean-Luc; Halvorsen, Sigrun; Hall, Trygve S; Larsen, Alf-Inge; Jensen, Svend Eggert; Arheden, Hakan; Atar, Dan; Clemmensen, Peter; Ripa, Maria Sejersten; Birnbaum, Yochai.
in: J ELECTROCARDIOL, Jahrgang 51, Nr. 4, 13.07.2018, S. 563-568.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging
AU - Allencherril, Joseph
AU - Fakhri, Yama
AU - Engblom, Henrik
AU - Heiberg, Einar
AU - Carlsson, Marcus
AU - Dubois-Rande, Jean-Luc
AU - Halvorsen, Sigrun
AU - Hall, Trygve S
AU - Larsen, Alf-Inge
AU - Jensen, Svend Eggert
AU - Arheden, Hakan
AU - Atar, Dan
AU - Clemmensen, Peter
AU - Ripa, Maria Sejersten
AU - Birnbaum, Yochai
N1 - Copyright © 2018 Elsevier Inc. All rights reserved.
PY - 2018/7/13
Y1 - 2018/7/13
N2 - BACKGROUND: Anteroseptal ST elevation myocardial infarction (STEMI) is traditionally defined on the electrocardiogram (ECG) by ST elevation (STE) in leads V1-V3, with or without involvement of lead V4. It is commonly taught that such infarcts affect the basal anteroseptal myocardial segment. While there are suggestions in the literature that Q waves limited to V1-V4 represent predominantly apical infarction, none have evaluated anteroseptal ST elevation territories. We compared the distribution of the myocardium at risk (MaR) in STEMI patients presenting with STE limited to V1-V4 and those with more extensive STE (V1-V6).METHODS: We identified patients in the MITOCARE study presenting with a first acute STEMI and new STE in at least two contiguous anterior leads from V1 to V6. Patients underwent cardiac magnetic resonance (CMR) imaging three to five days after acute infarction.RESULTS: Thirty-two patients met inclusion criteria. In patients with STE in V1-V4 (n = 20), myocardium at risk (MaR) > 50% was seen in 0%, 85%, 75%, 100%, and 90% in the basal anteroseptal, mid anteroseptal, apical anterior, apical septal segments, and apex, respectively. The group with STE in V1-V6 (n = 12), MaR > 50% was seen in 8%, 83%, 83%, 92%, and 83% of the same segments.CONCLUSIONS: Patients with acute STEMI and STE in leads V1-V4, exhibit MaR in predominantly apical territories and rarely in the basal anteroseptum. We found no evidence to support existence of isolated basal anteroseptal or septal STEMI. "Anteroapical" infarction is a more precise description than "anteroseptal" infarction for acute STEMI patients exhibiting STE in V1-V4.
AB - BACKGROUND: Anteroseptal ST elevation myocardial infarction (STEMI) is traditionally defined on the electrocardiogram (ECG) by ST elevation (STE) in leads V1-V3, with or without involvement of lead V4. It is commonly taught that such infarcts affect the basal anteroseptal myocardial segment. While there are suggestions in the literature that Q waves limited to V1-V4 represent predominantly apical infarction, none have evaluated anteroseptal ST elevation territories. We compared the distribution of the myocardium at risk (MaR) in STEMI patients presenting with STE limited to V1-V4 and those with more extensive STE (V1-V6).METHODS: We identified patients in the MITOCARE study presenting with a first acute STEMI and new STE in at least two contiguous anterior leads from V1 to V6. Patients underwent cardiac magnetic resonance (CMR) imaging three to five days after acute infarction.RESULTS: Thirty-two patients met inclusion criteria. In patients with STE in V1-V4 (n = 20), myocardium at risk (MaR) > 50% was seen in 0%, 85%, 75%, 100%, and 90% in the basal anteroseptal, mid anteroseptal, apical anterior, apical septal segments, and apex, respectively. The group with STE in V1-V6 (n = 12), MaR > 50% was seen in 8%, 83%, 83%, 92%, and 83% of the same segments.CONCLUSIONS: Patients with acute STEMI and STE in leads V1-V4, exhibit MaR in predominantly apical territories and rarely in the basal anteroseptum. We found no evidence to support existence of isolated basal anteroseptal or septal STEMI. "Anteroapical" infarction is a more precise description than "anteroseptal" infarction for acute STEMI patients exhibiting STE in V1-V4.
KW - Aged
KW - Double-Blind Method
KW - Electrocardiography
KW - Female
KW - Heart/diagnostic imaging
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - ST Elevation Myocardial Infarction/diagnosis
KW - Ventricular Function, Left
U2 - 10.1016/j.jelectrocard.2018.03.016
DO - 10.1016/j.jelectrocard.2018.03.016
M3 - SCORING: Journal article
C2 - 29996989
VL - 51
SP - 563
EP - 568
JO - J ELECTROCARDIOL
JF - J ELECTROCARDIOL
SN - 0022-0736
IS - 4
ER -