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Cardiac magnetic resonance evaluation of the extent of myocardial injury in patients with inferior ST elevation myocardial infarction and concomitant ST depression in leads V1-V3 : Analysis from the MITOCARE Study

Jia, Xiaoming; Heiberg, Einar LU ; Sejersten Ripa, Maria; Engblom, Henrik LU ; Carlsson, Marcus LU ; Halvorsen, Sigrun; Arheden, Håkan LU ; Atar, Dan; Clemmensen, Peter and Birnbaum, Yochai (2018) In Cardiology (Switzerland) 140(3). p.178-185
Abstract

The aim of our study was to examine the pathophysiology of ST depression (STD) in leads V1-V3 in the setting of inferior ST elevation myocardial infarction (iSTEMI) through the perspective of cardiac magnetic resonance (CMR). Methods: Differences in myocardial area at risk (MaR), infarct size, ejection fraction and myocardial segment involvement by CMR were compared in MITOCARE trial patients with first iSTEMI with ST elevation (STE), STD or no ST changes (NST) in V1-V3. The frontal plane projection of the inferior wall MaR in relationship to the anterior/posterior chest wall was calculated and compared between groups. Results: Fifty-six patients were included. Patients with STD (n = 38) and STE (n = 5) in V1-V3 had significantly larger... (More)

The aim of our study was to examine the pathophysiology of ST depression (STD) in leads V1-V3 in the setting of inferior ST elevation myocardial infarction (iSTEMI) through the perspective of cardiac magnetic resonance (CMR). Methods: Differences in myocardial area at risk (MaR), infarct size, ejection fraction and myocardial segment involvement by CMR were compared in MITOCARE trial patients with first iSTEMI with ST elevation (STE), STD or no ST changes (NST) in V1-V3. The frontal plane projection of the inferior wall MaR in relationship to the anterior/posterior chest wall was calculated and compared between groups. Results: Fifty-six patients were included. Patients with STD (n = 38) and STE (n = 5) in V1-V3 had significantly larger mean MaR compared to NST (n = 13; 32 ± 7%LV, 36 ± 10%LV and 26 ± 6%LV, respectively; p = 0.01). STD in leads V1-V3 was associated with more apical inferior and mid inferoseptal involvement and had a larger mean frontal plane projection of MaR compared with NST (24 ± 6%LV vs. 20 ± 6%LV, p = 0.04). Conclusion: STD in V1-V3 in iSTEMI is associated with larger MaR, more extension into the inferoseptal segments and likely results from greater frontal plane projection of the MaR, leading to reciprocal changes on the electrocardiogram.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac magnetic resonance, Inferior myocardial infarction, Precordial ST changes
in
Cardiology (Switzerland)
volume
140
issue
3
pages
8 pages
publisher
Karger
external identifiers
  • scopus:85055073210
ISSN
0008-6312
DOI
10.1159/000491745
language
English
LU publication?
yes
id
abdb37e5-08f2-47cb-9433-8c54bbc3132e
date added to LUP
2018-11-16 10:56:50
date last changed
2019-01-06 14:15:43
@article{abdb37e5-08f2-47cb-9433-8c54bbc3132e,
  abstract     = {<p>The aim of our study was to examine the pathophysiology of ST depression (STD) in leads V1-V3 in the setting of inferior ST elevation myocardial infarction (iSTEMI) through the perspective of cardiac magnetic resonance (CMR). Methods: Differences in myocardial area at risk (MaR), infarct size, ejection fraction and myocardial segment involvement by CMR were compared in MITOCARE trial patients with first iSTEMI with ST elevation (STE), STD or no ST changes (NST) in V1-V3. The frontal plane projection of the inferior wall MaR in relationship to the anterior/posterior chest wall was calculated and compared between groups. Results: Fifty-six patients were included. Patients with STD (n = 38) and STE (n = 5) in V1-V3 had significantly larger mean MaR compared to NST (n = 13; 32 ± 7%LV, 36 ± 10%LV and 26 ± 6%LV, respectively; p = 0.01). STD in leads V1-V3 was associated with more apical inferior and mid inferoseptal involvement and had a larger mean frontal plane projection of MaR compared with NST (24 ± 6%LV vs. 20 ± 6%LV, p = 0.04). Conclusion: STD in V1-V3 in iSTEMI is associated with larger MaR, more extension into the inferoseptal segments and likely results from greater frontal plane projection of the MaR, leading to reciprocal changes on the electrocardiogram.</p>},
  author       = {Jia, Xiaoming and Heiberg, Einar and Sejersten Ripa, Maria and Engblom, Henrik and Carlsson, Marcus and Halvorsen, Sigrun and Arheden, Håkan and Atar, Dan and Clemmensen, Peter and Birnbaum, Yochai},
  issn         = {0008-6312},
  keyword      = {Cardiac magnetic resonance,Inferior myocardial infarction,Precordial ST changes},
  language     = {eng},
  number       = {3},
  pages        = {178--185},
  publisher    = {Karger},
  series       = {Cardiology (Switzerland)},
  title        = {Cardiac magnetic resonance evaluation of the extent of myocardial injury in patients with inferior ST elevation myocardial infarction and concomitant ST depression in leads V1-V3 : Analysis from the MITOCARE Study},
  url          = {http://dx.doi.org/10.1159/000491745},
  volume       = {140},
  year         = {2018},
}