Petteri Kosonen

Central Hospital Central Finland, Jyväskylä, Province of Western Finland, Finland

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Publications (3)6.3 Total impact

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    ABSTRACT: Background Patients with acute ST-elevation myocardial infarction (STEMI) benefit substantially from emergent coronary reperfusion. The principal mechanism is to open the occluded coronary artery to minimize myocardial injury. Thus the size of the area at risk is a critical determinant of the patient outcome, although other factors, such as reperfusion injury, have major impact on the final infarct size. Acute coronary occlusion almost immediately induces metabolic changes within the myocardium, which can be assessed with both the electrocardiogram (ECG) and cardiac magnetic resonance (CMR) imaging.Methods The 12-lead ECG is the principal diagnostic method to detect and risk-stratify acute STEMI. However, to achieve a correct diagnosis, it is paramount to compare different ECG parameters with golden standards in imaging, such as CMR. In this review, we discuss aspects of ECG and CMR in the assessment of acute regional ischemic changes in the myocardium using the 17 segment model of the left ventricle presented by American Heart Association (AHA), and their relation to coronary artery anatomy.ResultsUsing the 17 segment model of AHA, the segments 12 and 16 remain controversial. There is an important overlap in myocardial blood supply at the antero-lateral region between LAD and LCx territories concerning these two segments.Conclusion No all-encompassing correlation can be found between ECG and CMR findings in acute ischemia with respect to coronary anatomy.
    Annals of Noninvasive Electrocardiology 09/2014; 19(6). DOI:10.1111/anec.12210 · 1.13 Impact Factor
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    ABSTRACT: Background: This prospective multicenter registry used intravascular ultrasound (IVUS) in patients with definite stent thrombosis (ST) to compare rates of incomplete stent apposition (ISA), stent fracture and stent expansion in patients treated with drug-eluting (DES) versus bare metal (BMS) stents. ST is a rare, but potential life threatening event after coronary stent implantation. The etiology seems to be multifactorial. Methods: 124 patients with definite ST were assessed by IVUS during the acute ST event. The study was conducted in 15 high-volume percutaneous coronary intervention -centers in the Nordic-Baltic countries. Results: In early or late ST there were no differences in ISA between DES and BMS. In very late ST, ISA was a more frequent finding in DES than in BMS (52% vs.16%; p=0.005) and the maximum ISA area was larger in DES compared to BMS (1.1 ± 2.3mm(2) vs. 0.1 ± 0.5mm(2); p=0.004). Further, ISA was more prevalent in sirolimus-eluting than in paclitaxel-eluting stents (58% vs. 37%; p=0.02). Stent fractures were found both in DES (16%) and BMS (24%); p=0.28, and not related to time of stent thrombosis occurrence. For stents with nominal diameters ≥ 2.75 mm, 38% of the DES and 22% of the BMS had a minimum stent area of less than 5mm(2); p=0.14. Conclusions: Very late stent thrombosis was more prevalent and associated with more extensive ISA in DES than in BMS treated patients. Stent fracture was a common finding in ST after DES and BMS implantation.
    International journal of cardiology 11/2012; 168(2). DOI:10.1016/j.ijcard.2012.10.033 · 4.04 Impact Factor
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    ABSTRACT: Isolated right ventricular infarction (RVI) is a rare event. The electrocardiographic (ECG) pattern of RVI, ST-elevation in lead V4R and in anterior chest leads V1-3 is similar to that of a proximal occlusion of a small, nondominant right coronary artery (RCA). The ECG changes may be misinterpreted as signs of infarction of the anterior wall. This paper describes a case of isolated temporary occlusion of the major side branches of the RCA during percutaneous coronary intervention, recognized by angiography findings and typical ECG changes. This case demonstrates how one might avoid wrong decisions even in the catheterization laboratory by putting attention to the anatomical interpretation of the ECG.
    Annals of Noninvasive Electrocardiology 02/2007; 12(1):83-7. DOI:10.1111/j.1542-474X.2007.00143.x · 1.13 Impact Factor

Publication Stats

19 Citations
6.30 Total Impact Points


  • 2014
    • Central Hospital Central Finland
      Jyväskylä, Province of Western Finland, Finland
  • 2012
    • University of Tampere
      Tammerfors, Pirkanmaa, Finland
  • 2007
    • Tampere University Hospital (TAUH)
      Tammerfors, Province of Western Finland, Finland