Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging
(2018) In Journal of Electrocardiology 51(4). p.563-568- Abstract
Background: Anteroseptal ST elevation myocardial infarction (STEMI) is traditionally defined on the electrocardiogram (ECG) by ST elevation (STE) in leads V1-V3, with or without involvement of lead V4. It is commonly taught that such infarcts affect the basal anteroseptal myocardial segment. While there are suggestions in the literature that Q waves limited to V1-V4 represent predominantly apical infarction, none have evaluated anteroseptal ST elevation territories. We compared the distribution of the myocardium at risk (MaR) in STEMI patients presenting with STE limited to V1-V4 and those with more extensive STE (V1-V6). Methods: We identified patients in the MITOCARE study presenting with a first acute STEMI and new STE in at least... (More)
Background: Anteroseptal ST elevation myocardial infarction (STEMI) is traditionally defined on the electrocardiogram (ECG) by ST elevation (STE) in leads V1-V3, with or without involvement of lead V4. It is commonly taught that such infarcts affect the basal anteroseptal myocardial segment. While there are suggestions in the literature that Q waves limited to V1-V4 represent predominantly apical infarction, none have evaluated anteroseptal ST elevation territories. We compared the distribution of the myocardium at risk (MaR) in STEMI patients presenting with STE limited to V1-V4 and those with more extensive STE (V1-V6). Methods: We identified patients in the MITOCARE study presenting with a first acute STEMI and new STE in at least two contiguous anterior leads from V1 to V6. Patients underwent cardiac magnetic resonance (CMR) imaging three to five days after acute infarction. Results: Thirty-two patients met inclusion criteria. In patients with STE in V1-V4 (n = 20), myocardium at risk (MaR) > 50% was seen in 0%, 85%, 75%, 100%, and 90% in the basal anteroseptal, mid anteroseptal, apical anterior, apical septal segments, and apex, respectively. The group with STE in V1-V6 (n = 12), MaR > 50% was seen in 8%, 83%, 83%, 92%, and 83% of the same segments. Conclusions: Patients with acute STEMI and STE in leads V1-V4, exhibit MaR in predominantly apical territories and rarely in the basal anteroseptum. We found no evidence to support existence of isolated basal anteroseptal or septal STEMI. “Anteroapical” infarction is a more precise description than “anteroseptal” infarction for acute STEMI patients exhibiting STE in V1-V4.
(Less)
- author
- organization
- publishing date
- 2018-07-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiology, Electrocardiography, Magnetic resonance imaging, Myocardial infarction, ST elevations
- in
- Journal of Electrocardiology
- volume
- 51
- issue
- 4
- pages
- 6 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85046749862
- pmid:29996989
- ISSN
- 0022-0736
- DOI
- 10.1016/j.jelectrocard.2018.03.016
- language
- English
- LU publication?
- yes
- id
- a9aa83ee-8896-4ab7-8342-9312fc490bba
- date added to LUP
- 2018-05-21 14:33:40
- date last changed
- 2024-03-18 09:44:31
@article{a9aa83ee-8896-4ab7-8342-9312fc490bba,
abstract = {{<p>Background: Anteroseptal ST elevation myocardial infarction (STEMI) is traditionally defined on the electrocardiogram (ECG) by ST elevation (STE) in leads V1-V3, with or without involvement of lead V4. It is commonly taught that such infarcts affect the basal anteroseptal myocardial segment. While there are suggestions in the literature that Q waves limited to V1-V4 represent predominantly apical infarction, none have evaluated anteroseptal ST elevation territories. We compared the distribution of the myocardium at risk (MaR) in STEMI patients presenting with STE limited to V1-V4 and those with more extensive STE (V1-V6). Methods: We identified patients in the MITOCARE study presenting with a first acute STEMI and new STE in at least two contiguous anterior leads from V1 to V6. Patients underwent cardiac magnetic resonance (CMR) imaging three to five days after acute infarction. Results: Thirty-two patients met inclusion criteria. In patients with STE in V1-V4 (n = 20), myocardium at risk (MaR) > 50% was seen in 0%, 85%, 75%, 100%, and 90% in the basal anteroseptal, mid anteroseptal, apical anterior, apical septal segments, and apex, respectively. The group with STE in V1-V6 (n = 12), MaR > 50% was seen in 8%, 83%, 83%, 92%, and 83% of the same segments. Conclusions: Patients with acute STEMI and STE in leads V1-V4, exhibit MaR in predominantly apical territories and rarely in the basal anteroseptum. We found no evidence to support existence of isolated basal anteroseptal or septal STEMI. “Anteroapical” infarction is a more precise description than “anteroseptal” infarction for acute STEMI patients exhibiting STE in V1-V4.</p>}},
author = {{Allencherril, Joseph and Fakhri, Yama and Engblom, Henrik and Heiberg, Einar and Carlsson, Marcus and Dubois-Rande, Jean Luc and Halvorsen, Sigrun and Hall, Trygve S. and Larsen, Alf Inge and Jensen, Svend Eggert and Arheden, Hakan and Atar, Dan and Clemmensen, Peter and Ripa, Maria Sejersten and Birnbaum, Yochai}},
issn = {{0022-0736}},
keywords = {{Cardiology; Electrocardiography; Magnetic resonance imaging; Myocardial infarction; ST elevations}},
language = {{eng}},
month = {{07}},
number = {{4}},
pages = {{563--568}},
publisher = {{Elsevier}},
series = {{Journal of Electrocardiology}},
title = {{Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging}},
url = {{http://dx.doi.org/10.1016/j.jelectrocard.2018.03.016}},
doi = {{10.1016/j.jelectrocard.2018.03.016}},
volume = {{51}},
year = {{2018}},
}