title: Intracoronary electrocardiogram and angina pectoris during percutaneous coronary interventions as an assessment of myocardial viability: comparison with low-dose dobutamine echocardiography.
abstract: The aims of this study were to evaluate the diagnostic value of intracoronary electrocardiogram (ECG) and presence of angina pectoris during percutaneous coronary interventions in the prediction of myocardial viability assessed by low-dose dobutamine echocardiography (LDDE). Seventy-one patients (60 men; mean age, 54 +/- 11 years) with recent Q-wave MI and angiographically documented regional wall motion abnormality in the presence of a significant (>/= 70%) nonocclusive stenosis of the infarct-related vessel who were referred for angioplasty were prospectively included in the study. The intracoronary ECG was recorded using coronary angioplasty guidewire. Significant ST segment elevation was defined as a new or worsening ST segment elevation of >/= 0.1 mV at 80 msec after the J-point. Angina pectoris was noted as present or absent during balloon inflation. All patients underwent LDDE for viability assessment. Significant ST segment elevation in the intracoronary ECG and chest pain were observed in 56 (78.9%) and 49 (69%) of the 71 patients. Viability was present on LDDE in 52 (92.9%) of 56 patients with and 3 (20%) of 15 without ST segment elevation. Viability was detected in 45 (91.8%) of 49 patients with and 10 (45.4%) of 22 without angina pectoris during balloon occlusion. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ST segment elevation for viability were 94.5%, 75%, 92.9%, 80%, and 90.1%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of angina pectoris for viability were 81.8%, 75%, 91.8%, 54.5%, and 80.3%, respectively. The present study demonstrated that a simple assessment of ST segment elevation in the intracoronary ECG or angina pectoris during coronary angioplasty can be used to assess myocardial viability identified by LDDE in patients with previous MI.
authors: Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey. abaci@erciyes.edu.tr
authors: Adnan
authors: A
authors: Abaci
authors: Abdurrahman
authors: A
authors: Oguzhan
authors: Ramazan
authors: R
authors: Topsakal
authors: Ergun
authors: E
authors: Seyfeli
authors: Yucel
authors: Y
authors: Yilmaz
authors: Namik Kemal
authors: NK
authors: Eryol
authors: Emrullah
authors: E
authors: Basar
authors: Ali
authors: A
authors: Ergin
mesh_terms: D000787:Angina Pectoris / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015906:Angioplasty, Balloon, Coronary; D002316:Cardiotonic Agents; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004280:Dobutamine; D004452:Echocardiography; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine