Clinical significance of changes in electrocardiographic R-wave voltage on chest leads in patients with acute anterior myocardial infarction

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• 作者：Satoshi Isobe ; Mitsuhiro Okada ; Akitada Ando ; Mamoru Nanasato ; Makoto Nonokawa ; Hideo Izawa ; Takahisa Kondo ; Makoto Hirai ; Mitsuhiro Yokota ; Yoshifumi Tanahashi ; Hidehiko Saito
• 刊名：Journal of Electrocardiology
• 出版年：2002
• 出版时间：July 2002
• 年：2002
• 卷：35
• 期：3
• 页码：173-180
• 全文大小：151 K

文摘

This article aims to clarify the clinical significance of changes in electrocardiographic (ECG) R-wave voltage on chest leads from 1 to 4 weeks in patients with acute anterior myocardial infarction (MI) in combination with echocardiographic findings and dual scintigraphic findings. Seventy-one patients with acute anterior MI who underwent emergency revascularization were subjected to ECG and echocardiography, at both 1 and 4 weeks, and to thallium-201 (TI) and iodine-123-[beta ]-methyl-p-iodophenyl pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT) about 1 week after the onset of MI. The total sum of ECG R-wave voltage on each chest lead was calculated. The mean defect ratio on TI and that on BMIPP derived from circumferential profile curve analysis were calculated. The percentage defect-discordant ratio of both SPECT images [( % ) discordance on TI/BMIPP] was obtained. The percentage increase ratio of ECG R-wave voltage on chest leads [( % ) increase of R wave] and the increase of left ventricular ejection fraction ([Delta ]EF) from 1 to 4 weeks were obtained. There were significant correlations between the ( % ) increase of R wave and the [Delta ]EF as well as between the ( % ) increase of R wave and the ( % ) discordance on TI/BMIPP (r = .63, P [lt ] .001; R = .74, P [lt ] .001). The reversibility of ECG R-wave voltage was related to cardiac functional improvement in addition to the discordance on the 2 images. Monitoring of changes in ECG R-wave voltage on chest leads is useful to detect the presence of myocardial viability and to evaluate functional evolution in patients with acute anterior MI.