Clinical significance of changes in electrocardiographic R-wave voltage on chest leads in patients with acute anterior myocardial infarction.
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-beta-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 (DeltaEF) from 1 to 4 weeks were obtained. There were significant correlations between the (%) increase of R wave and the DeltaEF 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.
Isobe
Satoshi
S
Division of Cardiology, First Department of Internal Medicine, Nagoya University Graduate School of Medicine, Japan. sisobe@med.nagoya-u.ac.jp
Okada
Mitsuhiro
M
Ando
Akitada
A
Nanasato
Mamoru
M
Nonokawa
Makoto
M
Izawa
Hideo
H
Kondo
Takahisa
T
Hirai
Makoto
M
Yokota
Mitsuhiro
M
Tanahashi
Yoshifumi
Y
Saito
Hidehiko
H
D004452:Echocardiography; D004562:Electrocardiography; D005227:Fatty Acids; D005260:Female; D006801:Humans; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D005227:Fatty Acids; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; C049338:iodofiltic acid