Spatial repolarization abnormalities in old myocardial infarction.
Conventional electrocardiogram criteria for myocardial infarction (MI) rely on QRS features, but ST-T segment is also affected. We recorded body surface potential mapping in 24 patients with prior MI and in 24 controls. T-wave maximum amplitude and QRS and ST-T integrals were automatically determined. Old MI was verified by magnetic resonance imaging. ST-T integral and T-wave maximum amplitude outperformed QRS integral in detecting MI, with area under receiver operating characteristic curve of 94%, 95%, and 83%, respectively. ST-T integral performed better in non-Q-wave than Q-wave MI, with area under receiver operating characteristic curve of 97% and 92%, respectively. QRS integral correlated negatively with ST-T integral in patients with MI (r = -0.58, P < .001) and positively in controls (r = 0.45, P < .001). In conclusion, ST-T integral proved equal to QRS integral in old MI detection. Inclusion of ventricular repolarization phase and development of electrocardiographic analysis over larger chest area may improve the QRS-based diagnosis of old myocardial infarction.
Vesterinen
Paula
P
Division of Cardiology, Helsinki University Central Hospital, Helsinki, FIN 00029 HUCH, Finland. paula.vesterinen@kolumbus.fi
Hänninen
Helena
H
Karvonen
Milla
M
Lauerma
Kirsi
K
Holmström
Miia
M
Mäkijärvi
Markku
M
Väänänen
Heikki
H
Stenroos
Matti
M
Nenonen
Jukka
J
Katila
Toivo
T
Toivonen
Lauri
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D018780:Body Surface Potential Mapping / Q000379:methods / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000145:classification / Q000503:physiopathology*; D012372:ROC Curve