Clinical significance of changes in electrocardiographic R-wave voltage on chest leads in patients with acute anterior myocardial infarction

Satoshi Isobe, Mitsuhiro Okada, Akitada Ando, Mamoru Nanasato, Makoto Nonokawa, Hideo Izawa, Takahisa Kondo, Makoto Hirai, Mitsuhiro Yokota, Yoshifumi Tanahashi, Hidehiko Saito

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Abstract

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.

Original languageEnglish
Pages (from-to)173-180
Number of pages8
JournalJournal of Electrocardiology
Volume35
Issue number3
DOIs
Publication statusPublished - 01-01-2002

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Isobe, S., Okada, M., Ando, A., Nanasato, M., Nonokawa, M., Izawa, H., Kondo, T., Hirai, M., Yokota, M., Tanahashi, Y., & Saito, H. (2002). Clinical significance of changes in electrocardiographic R-wave voltage on chest leads in patients with acute anterior myocardial infarction. Journal of Electrocardiology, 35(3), 173-180. https://doi.org/10.1054/jelc.2002.33761