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Correlation of ST changes in leads V4–V6 to area of ischemia by CMR in inferior STEMI

Jia, Xiaoming ; Heiberg, Einar LU ; Ripa, Maria Sejersten ; Engblom, Henrik LU ; Halvorsen, Sigrun ; Arheden, Håkan LU ; Atar, Dan ; Clemmensen, Peter and Birnbaum, Yochai (2018) In Scandinavian Cardiovascular Journal 52(4). p.189-195
Abstract

Objective. We aim to determine the correlation between ST-segment changes in leads V4–V6 and the extent of myocardial injury by cardiac magnetic resonance (CMR) in patients with inferior ST elevation (STE) myocardial infarction (iSTEMI). Design. Admission electrocardiogram and CMR data from the MITOCARE trial were used. Differences in mean myocardium at risk, infarct size, ejection fraction and myocardial segment involvement by CMR were compared in patients with first iSTEMI with STE, ST depression (STD) or no ST changes (NST) in V4–V6. Myocardial segment involvement was further evaluated by comparing proportion of patients in each group with ≥25% and ≥50% segment involvement. Results. Fifty-four patients were included. Patients with... (More)

Objective. We aim to determine the correlation between ST-segment changes in leads V4–V6 and the extent of myocardial injury by cardiac magnetic resonance (CMR) in patients with inferior ST elevation (STE) myocardial infarction (iSTEMI). Design. Admission electrocardiogram and CMR data from the MITOCARE trial were used. Differences in mean myocardium at risk, infarct size, ejection fraction and myocardial segment involvement by CMR were compared in patients with first iSTEMI with STE, ST depression (STD) or no ST changes (NST) in V4–V6. Myocardial segment involvement was further evaluated by comparing proportion of patients in each group with ≥25% and ≥50% segment involvement. Results. Fifty-four patients were included. Patients with STE (n = 22) and STD (n = 16) in V4–V6 had significantly lower ejection fraction compared to NST (n = 16) (48% vs 48% vs 54%, p = .02). STE showed more apical, apical lateral and mid-inferolateral involvement but less basal inferior involvement than NST. STD exhibited greater basal inferoseptal involvement compared to STE. There were more patients with STE that had ≥25% and ≥50% apical lateral involvement compared with STD and NST groups. Patients with STD were more likely to have ≥25% and ≥50% basal inferoseptal involvement compared with STE and NST groups.Conclusion. Our study suggests that in iSTEMI, ST changes in the precordial leads V4–V6 correlates with greater myocardial injury and distribution of myocardium at risk.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiac magnetic resonance, Inferior myocardial infarction, precordial ST changes
in
Scandinavian Cardiovascular Journal
volume
52
issue
4
pages
189 - 195
publisher
Taylor & Francis
external identifiers
  • pmid:29595340
  • scopus:85044506801
ISSN
1401-7431
DOI
10.1080/14017431.2018.1458145
language
English
LU publication?
yes
id
d6bff961-e122-49ef-bd12-1ddd0b9c6be5
date added to LUP
2018-04-10 13:51:38
date last changed
2020-01-13 00:37:05
@article{d6bff961-e122-49ef-bd12-1ddd0b9c6be5,
  abstract     = {<p>Objective. We aim to determine the correlation between ST-segment changes in leads V4–V6 and the extent of myocardial injury by cardiac magnetic resonance (CMR) in patients with inferior ST elevation (STE) myocardial infarction (iSTEMI). Design. Admission electrocardiogram and CMR data from the MITOCARE trial were used. Differences in mean myocardium at risk, infarct size, ejection fraction and myocardial segment involvement by CMR were compared in patients with first iSTEMI with STE, ST depression (STD) or no ST changes (NST) in V4–V6. Myocardial segment involvement was further evaluated by comparing proportion of patients in each group with ≥25% and ≥50% segment involvement. Results. Fifty-four patients were included. Patients with STE (n = 22) and STD (n = 16) in V4–V6 had significantly lower ejection fraction compared to NST (n = 16) (48% vs 48% vs 54%, p = .02). STE showed more apical, apical lateral and mid-inferolateral involvement but less basal inferior involvement than NST. STD exhibited greater basal inferoseptal involvement compared to STE. There were more patients with STE that had ≥25% and ≥50% apical lateral involvement compared with STD and NST groups. Patients with STD were more likely to have ≥25% and ≥50% basal inferoseptal involvement compared with STE and NST groups.Conclusion. Our study suggests that in iSTEMI, ST changes in the precordial leads V4–V6 correlates with greater myocardial injury and distribution of myocardium at risk.</p>},
  author       = {Jia, Xiaoming and Heiberg, Einar and Ripa, Maria Sejersten and Engblom, Henrik and Halvorsen, Sigrun and Arheden, Håkan and Atar, Dan and Clemmensen, Peter and Birnbaum, Yochai},
  issn         = {1401-7431},
  language     = {eng},
  month        = {03},
  number       = {4},
  pages        = {189--195},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Cardiovascular Journal},
  title        = {Correlation of ST changes in leads V4–V6 to area of ischemia by CMR in inferior STEMI},
  url          = {http://dx.doi.org/10.1080/14017431.2018.1458145},
  doi          = {10.1080/14017431.2018.1458145},
  volume       = {52},
  year         = {2018},
}