title: ST-segment depression in aVR as a predictor of culprit artery and infarct size in acute inferior wall ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  ST-segment depression in lead aVR in acute inferior wall ST-segment elevation myocardial infarction (STEMI) has recently been suggested as a predictor of left circumflex (LCx) artery involvement. The purpose of this study is to evaluate the clinical significance of aVR depression during inferior wall STEMI.
  
  
  METHODS
  This study included 106 consecutive patients who presented with inferior wall STEMI and underwent urgent coronary angiogram. Clinical and angiographic findings were compared between patients with and without aVR depression > or = 0.1 mV.
  
  
  RESULTS
  The sensitivity and specificity of aVR depression as a predictor of LCx infarction were 53% and 86%, respectively. In patients with right coronary artery infarction, aVR depression was associated with increased cardiac enzymes and the involvement of a large posterolateral branch, which may explain the larger infarction.
  
  
  CONCLUSIONS
  ST-segment depression in lead aVR in inferior wall STEMI predicts LCx infarction or larger RCA infarction involving a large posterolateral branch.
authors.affiliation: Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York, NY 10003, USA. yumikanei@hotmail.com
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kanei
authors.forename: Jyoti
authors.initials: J
authors.lastname: Sharma
authors.forename: Ravi
authors.initials: R
authors.lastname: Diwan
authors.forename: Ron
authors.initials: R
authors.lastname: Sklash
authors.forename: Lori L
authors.initials: LL
authors.lastname: Vales
authors.forename: John T
authors.initials: JT
authors.lastname: Fox
authors.forename: Paul
authors.initials: P
authors.lastname: Schweitzer
mesh_terms: D003324:Coronary Artery Disease / 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