Article

Determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction with ST-segment elevation.

Internal Medicine 2, Oita University, Yufu, Japan.
Journal of electrocardiology (impact factor: 1.08). 01/2009; 42(2):112-7. DOI:10.1016/j.jelectrocard.2008.10.006
Source: PubMed

ABSTRACT This study aimed to clarify the determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction (AAMI).
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.
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).
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.

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Keywords

AAMI
 
anterior wall acute myocardial infarction
 
apex
 
aVF
 
determinants
 
distal LAD occlusion
 
emergency coronary angiographic findings
 
first AAMI
 
greater ST-segment level
 
inferior wall
 
LAD occlusion
 
leads II
 
left anterior descending coronary artery
 
lower ST-segment level
 
medium LAD
 
proximal LAD occlusion
 
short
 
ST-segment elevation AAMI
 
ST-segment level
 
ST-segment levels
 

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