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.
  
  
  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 (SigmaR) 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 SigmaR and the absolute increase in LV ejection fraction from the acute to the subacute phase (DeltaEF) were also calculated. The SigmaR in the subacute phase was significantly greater than that in the acute phase (p<0.0001). The % increase in SigmaR significantly correlated with the DeltaEF (r=0.57, p<0.0001). The % increase in SigmaR 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.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya 462-0802, Japan. sisobe@med.nagoya-u.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Isobe
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takada
authors.forename: Akitada
authors.initials: A
authors.lastname: Ando
authors.forename: Satoru
authors.initials: S
authors.lastname: Ohshima
authors.forename: Kiyoyasu
authors.initials: K
authors.lastname: Yamada
authors.forename: Mamoru
authors.initials: M
authors.lastname: Nanasato
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Unno
authors.forename: Takuo
authors.initials: T
authors.lastname: Ogawa
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kondo
authors.forename: Hideo
authors.initials: H
authors.lastname: Izawa
authors.forename: Yasuya
authors.initials: Y
authors.lastname: Inden
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirai
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003326:Coronary Circulation; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D015425:Myocardial Reperfusion; D009204:Myocardial Revascularization; D011379:Prognosis; D011877:Radionuclide Imaging / Q000379:methods; D013794:Thallium Radioisotopes; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D007457:Iodine Radioisotopes; D013794:Thallium Radioisotopes