Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction

Satoshi Isobe, Yasuo Takada, Akitada Ando, Satoru Ohshima, Kiyoyasu Yamada, Mamoru Nanasato, Kazumasa Unno, Takuo Ogawa, Takahisa Kondo, Hideo Izawa, Yasuya Inden, Makoto Hirai, Toyoaki Murohara

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The physiological mechanism of the increase in the electrocardiographic (ECG) R-wave voltage after revascularization in patients with acute myocardial infarction (MI) needs to be elucidated. Methods and Results: One hundred and thirty-eight MI patients (83: anterior MI, 45: inferior MI, 10: lateral MI) underwent ECG and echocardiography in both the acute and subacute phases after emergency revascularization, as well as a resting thallium-201/iodine-123 15-p-iodophenyl-3-(R,S)-methyl pentadecanoic acid myocardial scintigraphy in the acute phase. The total sum of the R-wave voltage (ΣR) was calculated over multiple leads on ECG for each infarcted lesion. Scintigraphic defect on each tracer was expressed as the percentage (%) defect of the total left ventricular (LV) myocardium. The % defect-discordance on both images in the acute phase and the % increase in ΣR and the absolute increase in LV ejection fraction from the acute to the subacute phase (ΔEF) were also calculated. The ΣR in the subacute phase was significantly greater than that in the acute phase (p<0.0001). The % increase in ΣR significantly correlated with the ΔEF (r=0.57, p<0.0001). The % increase in ΣR also correlated with the % defect-discordance (r=0.68, p<0.0001). Conclusions: The increase in the ECG R-wave voltage reflects not only the improvement in myocardial perfusion but also the presence of salvaged myocardium after revascularization in acute MI patients.

Original languageEnglish
Pages (from-to)1385-1391
Number of pages7
JournalCirculation Journal
Volume70
Issue number11
DOIs
Publication statusPublished - 08-11-2006

Fingerprint

Myocardial Infarction
Myocardium
Inferior Wall Myocardial Infarction
Myocardial Perfusion Imaging
Thallium
Iodine
Stroke Volume
Echocardiography
Emergencies
Perfusion

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Isobe, S., Takada, Y., Ando, A., Ohshima, S., Yamada, K., Nanasato, M., ... Murohara, T. (2006). Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction. Circulation Journal, 70(11), 1385-1391. https://doi.org/10.1253/circj.70.1385
Isobe, Satoshi ; Takada, Yasuo ; Ando, Akitada ; Ohshima, Satoru ; Yamada, Kiyoyasu ; Nanasato, Mamoru ; Unno, Kazumasa ; Ogawa, Takuo ; Kondo, Takahisa ; Izawa, Hideo ; Inden, Yasuya ; Hirai, Makoto ; Murohara, Toyoaki. / Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction. In: Circulation Journal. 2006 ; Vol. 70, No. 11. pp. 1385-1391.
@article{5b45ee0d3a024aa79bb5376d85a7784a,
title = "Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction",
abstract = "Background: The physiological mechanism of the increase in the electrocardiographic (ECG) R-wave voltage after revascularization in patients with acute myocardial infarction (MI) needs to be elucidated. Methods and Results: One hundred and thirty-eight MI patients (83: anterior MI, 45: inferior MI, 10: lateral MI) underwent ECG and echocardiography in both the acute and subacute phases after emergency revascularization, as well as a resting thallium-201/iodine-123 15-p-iodophenyl-3-(R,S)-methyl pentadecanoic acid myocardial scintigraphy in the acute phase. The total sum of the R-wave voltage (ΣR) was calculated over multiple leads on ECG for each infarcted lesion. Scintigraphic defect on each tracer was expressed as the percentage ({\%}) defect of the total left ventricular (LV) myocardium. The {\%} defect-discordance on both images in the acute phase and the {\%} increase in ΣR and the absolute increase in LV ejection fraction from the acute to the subacute phase (ΔEF) were also calculated. The ΣR in the subacute phase was significantly greater than that in the acute phase (p<0.0001). The {\%} increase in ΣR significantly correlated with the ΔEF (r=0.57, p<0.0001). The {\%} increase in ΣR also correlated with the {\%} defect-discordance (r=0.68, p<0.0001). Conclusions: The increase in the ECG R-wave voltage reflects not only the improvement in myocardial perfusion but also the presence of salvaged myocardium after revascularization in acute MI patients.",
author = "Satoshi Isobe and Yasuo Takada and Akitada Ando and Satoru Ohshima and Kiyoyasu Yamada and Mamoru Nanasato and Kazumasa Unno and Takuo Ogawa and Takahisa Kondo and Hideo Izawa and Yasuya Inden and Makoto Hirai and Toyoaki Murohara",
year = "2006",
month = "11",
day = "8",
doi = "10.1253/circj.70.1385",
language = "English",
volume = "70",
pages = "1385--1391",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "11",

}

Isobe, S, Takada, Y, Ando, A, Ohshima, S, Yamada, K, Nanasato, M, Unno, K, Ogawa, T, Kondo, T, Izawa, H, Inden, Y, Hirai, M & Murohara, T 2006, 'Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction', Circulation Journal, vol. 70, no. 11, pp. 1385-1391. https://doi.org/10.1253/circj.70.1385

Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction. / Isobe, Satoshi; Takada, Yasuo; Ando, Akitada; Ohshima, Satoru; Yamada, Kiyoyasu; Nanasato, Mamoru; Unno, Kazumasa; Ogawa, Takuo; Kondo, Takahisa; Izawa, Hideo; Inden, Yasuya; Hirai, Makoto; Murohara, Toyoaki.

In: Circulation Journal, Vol. 70, No. 11, 08.11.2006, p. 1385-1391.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction

AU - Isobe, Satoshi

AU - Takada, Yasuo

AU - Ando, Akitada

AU - Ohshima, Satoru

AU - Yamada, Kiyoyasu

AU - Nanasato, Mamoru

AU - Unno, Kazumasa

AU - Ogawa, Takuo

AU - Kondo, Takahisa

AU - Izawa, Hideo

AU - Inden, Yasuya

AU - Hirai, Makoto

AU - Murohara, Toyoaki

PY - 2006/11/8

Y1 - 2006/11/8

N2 - Background: The physiological mechanism of the increase in the electrocardiographic (ECG) R-wave voltage after revascularization in patients with acute myocardial infarction (MI) needs to be elucidated. Methods and Results: One hundred and thirty-eight MI patients (83: anterior MI, 45: inferior MI, 10: lateral MI) underwent ECG and echocardiography in both the acute and subacute phases after emergency revascularization, as well as a resting thallium-201/iodine-123 15-p-iodophenyl-3-(R,S)-methyl pentadecanoic acid myocardial scintigraphy in the acute phase. The total sum of the R-wave voltage (ΣR) was calculated over multiple leads on ECG for each infarcted lesion. Scintigraphic defect on each tracer was expressed as the percentage (%) defect of the total left ventricular (LV) myocardium. The % defect-discordance on both images in the acute phase and the % increase in ΣR and the absolute increase in LV ejection fraction from the acute to the subacute phase (ΔEF) were also calculated. The ΣR in the subacute phase was significantly greater than that in the acute phase (p<0.0001). The % increase in ΣR significantly correlated with the ΔEF (r=0.57, p<0.0001). The % increase in ΣR also correlated with the % defect-discordance (r=0.68, p<0.0001). Conclusions: The increase in the ECG R-wave voltage reflects not only the improvement in myocardial perfusion but also the presence of salvaged myocardium after revascularization in acute MI patients.

AB - Background: The physiological mechanism of the increase in the electrocardiographic (ECG) R-wave voltage after revascularization in patients with acute myocardial infarction (MI) needs to be elucidated. Methods and Results: One hundred and thirty-eight MI patients (83: anterior MI, 45: inferior MI, 10: lateral MI) underwent ECG and echocardiography in both the acute and subacute phases after emergency revascularization, as well as a resting thallium-201/iodine-123 15-p-iodophenyl-3-(R,S)-methyl pentadecanoic acid myocardial scintigraphy in the acute phase. The total sum of the R-wave voltage (ΣR) was calculated over multiple leads on ECG for each infarcted lesion. Scintigraphic defect on each tracer was expressed as the percentage (%) defect of the total left ventricular (LV) myocardium. The % defect-discordance on both images in the acute phase and the % increase in ΣR and the absolute increase in LV ejection fraction from the acute to the subacute phase (ΔEF) were also calculated. The ΣR in the subacute phase was significantly greater than that in the acute phase (p<0.0001). The % increase in ΣR significantly correlated with the ΔEF (r=0.57, p<0.0001). The % increase in ΣR also correlated with the % defect-discordance (r=0.68, p<0.0001). Conclusions: The increase in the ECG R-wave voltage reflects not only the improvement in myocardial perfusion but also the presence of salvaged myocardium after revascularization in acute MI patients.

UR - http://www.scopus.com/inward/record.url?scp=33750540616&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750540616&partnerID=8YFLogxK

U2 - 10.1253/circj.70.1385

DO - 10.1253/circj.70.1385

M3 - Article

C2 - 17062958

AN - SCOPUS:33750540616

VL - 70

SP - 1385

EP - 1391

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 11

ER -