TY - JOUR
T1 - Clinical significance of changes in electrocardiographic R-wave voltage on chest leads in patients with acute anterior myocardial infarction
AU - Isobe, Satoshi
AU - Okada, Mitsuhiro
AU - Ando, Akitada
AU - Nanasato, Mamoru
AU - Nonokawa, Makoto
AU - Izawa, Hideo
AU - Kondo, Takahisa
AU - Hirai, Makoto
AU - Yokota, Mitsuhiro
AU - Tanahashi, Yoshifumi
AU - Saito, Hidehiko
PY - 2002
Y1 - 2002
N2 - This article aims to clarify the clinical significance of changes in electrocardiographic (ECG) R-wave voltage on chest leads from 1 to 4 weeks in patients with acute anterior myocardial infarction (MI) in combination with echocardiographic findings and dual scintigraphic findings. Seventy-one patients with acute anterior MI who underwent emergency revascularization were subjected to ECG and echocardiography, at both 1 and 4 weeks, and to thallium-201 (TI) and iodine-123-β-methyl-p-iodophenyl pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT) about 1 week after the onset of MI. The total sum of ECG R-wave voltage on each chest lead was calculated. The mean defect ratio on TI and that on BMIPP derived from circumferential profile curve analysis were calculated. The percentage defect-discordant ratio of both SPECT images [(%) discordance on TI/BMIPP] was obtained. The percentage increase ratio of ECG R-wave voltage on chest leads [(%) increase of R wave] and the increase of left ventricular ejection fraction (ΔEF) from 1 to 4 weeks were obtained. There were significant correlations between the (%) increase of R wave and the ΔEF as well as between the (%) increase of R wave and the (%) discordance on TI/BMIPP (r = .63, P < .001; r = .74, P < .001). The reversibility of ECG R-wave voltage was related to cardiac functional improvement in addition to the discordance on the 2 images. Monitoring of changes in ECG R-wave voltage on chest leads is useful to detect the presence of myocardial viability and to evaluate functional evolution in patients with acute anterior MI.
AB - This article aims to clarify the clinical significance of changes in electrocardiographic (ECG) R-wave voltage on chest leads from 1 to 4 weeks in patients with acute anterior myocardial infarction (MI) in combination with echocardiographic findings and dual scintigraphic findings. Seventy-one patients with acute anterior MI who underwent emergency revascularization were subjected to ECG and echocardiography, at both 1 and 4 weeks, and to thallium-201 (TI) and iodine-123-β-methyl-p-iodophenyl pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT) about 1 week after the onset of MI. The total sum of ECG R-wave voltage on each chest lead was calculated. The mean defect ratio on TI and that on BMIPP derived from circumferential profile curve analysis were calculated. The percentage defect-discordant ratio of both SPECT images [(%) discordance on TI/BMIPP] was obtained. The percentage increase ratio of ECG R-wave voltage on chest leads [(%) increase of R wave] and the increase of left ventricular ejection fraction (ΔEF) from 1 to 4 weeks were obtained. There were significant correlations between the (%) increase of R wave and the ΔEF as well as between the (%) increase of R wave and the (%) discordance on TI/BMIPP (r = .63, P < .001; r = .74, P < .001). The reversibility of ECG R-wave voltage was related to cardiac functional improvement in addition to the discordance on the 2 images. Monitoring of changes in ECG R-wave voltage on chest leads is useful to detect the presence of myocardial viability and to evaluate functional evolution in patients with acute anterior MI.
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U2 - 10.1054/jelc.2002.33761
DO - 10.1054/jelc.2002.33761
M3 - Article
C2 - 12122607
AN - SCOPUS:0036077178
SN - 0022-0736
VL - 35
SP - 173
EP - 180
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 3
ER -