title: Determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction with ST-segment elevation.
abstract: BACKGROUND
  This study aimed to clarify the determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction (AAMI).
  
  
  METHODS
  We analyzed ST-segment levels in all 12 leads on admission and emergency coronary angiographic findings in 261 patients with a first AAMI with ST-segment elevation. The length of the left anterior descending coronary artery (LAD) was classified as follows: short = not reaching the apex; medium = perfusing less than 25% of the inferior wall; long = perfusing 25% or more of the inferior wall.
  
  
  RESULTS
  The ST-segment level in lead aVR correlated significantly with the ST-segment levels in leads I, II, III, aVF, V(1), and V(3-6), especially with those in leads II and V(6) (r = -0.63, P < .001; r = -0.61, P < .001; respectively). Patients with a proximal LAD occlusion had a greater ST-segment level in lead aVR than those with a distal LAD occlusion (P < .001). Patients with a long LAD had a lower ST-segment level than those with a short or medium LAD (P < .05).
  
  
  CONCLUSIONS
  The ST-segment levels, especially in leads II and V(6), the site of the LAD occlusion, and the length of the LAD affect the ST-segment level in lead aVR in ST-segment elevation AAMI.
authors.affiliation: Internal Medicine 2, Oita University, Yufu, Japan.
authors.forename: Munenori
authors.initials: M
authors.lastname: Kotoku
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
authors.forename: Yusei
authors.initials: Y
authors.lastname: Abe
authors.forename: Junichi
authors.initials: J
authors.lastname: Kadota
mesh_terms: D000465:Algorithms; D023921:Coronary Stenosis / Q000150:complications* / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity