Correlation of ST changes in leads V4-V6 to area of ischemia by CMR in inferior STEMI
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Correlation of ST changes in leads V4-V6 to area of ischemia by CMR in inferior STEMI. / Jia, Xiaoming; Heiberg, Einar; Ripa, Maria Sejersten; Engblom, Henrik; Halvorsen, Sigrun; Arheden, Håkan; Atar, Dan; Clemmensen, Peter; Birnbaum, Yochai.
in: SCAND CARDIOVASC J, Jahrgang 52, Nr. 4, 08.2018, S. 189-195.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Correlation of ST changes in leads V4-V6 to area of ischemia by CMR in inferior STEMI
AU - Jia, Xiaoming
AU - Heiberg, Einar
AU - Ripa, Maria Sejersten
AU - Engblom, Henrik
AU - Halvorsen, Sigrun
AU - Arheden, Håkan
AU - Atar, Dan
AU - Clemmensen, Peter
AU - Birnbaum, Yochai
PY - 2018/8
Y1 - 2018/8
N2 - OBJECTIVE: We aim to determine the correlation between ST-segment changes in leads V4-V6 and the extent of myocardial injury by cardiac magnetic resonance (CMR) in patients with inferior ST elevation (STE) myocardial infarction (iSTEMI).DESIGN: Admission electrocardiogram and CMR data from the MITOCARE trial were used. Differences in mean myocardium at risk, infarct size, ejection fraction and myocardial segment involvement by CMR were compared in patients with first iSTEMI with STE, ST depression (STD) or no ST changes (NST) in V4-V6. Myocardial segment involvement was further evaluated by comparing proportion of patients in each group with ≥25% and ≥50% segment involvement.RESULTS: Fifty-four patients were included. Patients with STE (n = 22) and STD (n = 16) in V4-V6 had significantly lower ejection fraction compared to NST (n = 16) (48% vs 48% vs 54%, p = .02). STE showed more apical, apical lateral and mid-inferolateral involvement but less basal inferior involvement than NST. STD exhibited greater basal inferoseptal involvement compared to STE. There were more patients with STE that had ≥25% and ≥50% apical lateral involvement compared with STD and NST groups. Patients with STD were more likely to have ≥25% and ≥50% basal inferoseptal involvement compared with STE and NST groups.CONCLUSION: Our study suggests that in iSTEMI, ST changes in the precordial leads V4-V6 correlates with greater myocardial injury and distribution of myocardium at risk.
AB - OBJECTIVE: We aim to determine the correlation between ST-segment changes in leads V4-V6 and the extent of myocardial injury by cardiac magnetic resonance (CMR) in patients with inferior ST elevation (STE) myocardial infarction (iSTEMI).DESIGN: Admission electrocardiogram and CMR data from the MITOCARE trial were used. Differences in mean myocardium at risk, infarct size, ejection fraction and myocardial segment involvement by CMR were compared in patients with first iSTEMI with STE, ST depression (STD) or no ST changes (NST) in V4-V6. Myocardial segment involvement was further evaluated by comparing proportion of patients in each group with ≥25% and ≥50% segment involvement.RESULTS: Fifty-four patients were included. Patients with STE (n = 22) and STD (n = 16) in V4-V6 had significantly lower ejection fraction compared to NST (n = 16) (48% vs 48% vs 54%, p = .02). STE showed more apical, apical lateral and mid-inferolateral involvement but less basal inferior involvement than NST. STD exhibited greater basal inferoseptal involvement compared to STE. There were more patients with STE that had ≥25% and ≥50% apical lateral involvement compared with STD and NST groups. Patients with STD were more likely to have ≥25% and ≥50% basal inferoseptal involvement compared with STE and NST groups.CONCLUSION: Our study suggests that in iSTEMI, ST changes in the precordial leads V4-V6 correlates with greater myocardial injury and distribution of myocardium at risk.
KW - Action Potentials
KW - Clinical Trials, Phase II as Topic
KW - Electrocardiography
KW - Female
KW - Heart Rate
KW - Humans
KW - Inferior Wall Myocardial Infarction/diagnostic imaging
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Myocardium/pathology
KW - Predictive Value of Tests
KW - Prognosis
KW - Randomized Controlled Trials as Topic
KW - ST Elevation Myocardial Infarction/diagnostic imaging
U2 - 10.1080/14017431.2018.1458145
DO - 10.1080/14017431.2018.1458145
M3 - SCORING: Journal article
C2 - 29595340
VL - 52
SP - 189
EP - 195
JO - SCAND CARDIOVASC J
JF - SCAND CARDIOVASC J
SN - 1401-7431
IS - 4
ER -