Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction.
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.
Isobe
Satoshi
S
Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya 462-0802, Japan. sisobe@med.nagoya-u.ac.jp
Takada
Yasuo
Y
Ando
Akitada
A
Ohshima
Satoru
S
Yamada
Kiyoyasu
K
Nanasato
Mamoru
M
Unno
Kazumasa
K
Ogawa
Takuo
T
Kondo
Takahisa
T
Izawa
Hideo
H
Inden
Yasuya
Y
Hirai
Makoto
M
Murohara
Toyoaki
T
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
D007457:Iodine Radioisotopes; D013794:Thallium Radioisotopes