Precordial ST-segment depression during acute inferior myocardial infarction: clinical, scintigraphic and angiographic correlations
The cause and associated pathophysiology of precordial ST-segment depression during acute inferior myocardial infarction (IMI) are controversial. To investigate this problem, electrocardiographic findings in 48 consecutive patients with acute IMI were prospectively compared with results of coronary angiography, submaximal exercise thallium-201 (/sup 201/Tl) scintigraphy and multigated blood pool imaging, all obtained 2 weeks after IMI, and with clinical follow-up at 3 months. Patients were classified according to the admission ECG obtained 3.3 +/- 3.1 hours after the onset of chest pain. Twenty-one patients (group A) had no or <1.0 mm ST-segment depression, and 27 (group B) had greater than or equal to1.0 mm ST-segment depression in two or more precordial (V/sub 1-6/) leads. Patients in group B had more prolonged chest pain after admission to the coronary care unit than those in group A (2.8 +/- 3.0 vs 1.2 +/- 1.1 hours, p<0.03), greater summed ST-segment elevation in leads II, III, aV/sub F/ (6.7 +/- 4.7 vs 3.3 +/- 4.5 mm, p<0.02), higher plasma peak creatine kinase levels (1133 +/- 781 vs 653 +/- 482 IU/l, p<0.01), a higher prevalence of ''true posterior'' infarction by ECG criteria (26% vs 5%, p<0.05), a lower radionuclide ejection fraction (46 +/- 9% vs 54 +/- 6%, p<0.001), more extensive infarct-related asynergy (p<0.001) and /sup 201/Tl perfusion abnormalities (p<0.01), more complications during hospitalization (p<0.03), and more cardiac events at 3 months (p<0.02). There were no significant differences between group A and group B in the extent of underlying coronary disease, prevalence of left anterior descending coronary artery disease, exercise-induced ST-segment depression or angina, /sup 201/Tl defects or wall motion abnormalities in anterior or septal segments.
- Research Organization:
- Univ. of Virginia Hospital, Charlottesville
- OSTI ID:
- 6432531
- Journal Information:
- Circulation; (United States), Journal Name: Circulation; (United States) Vol. 66:4; ISSN CIRCA
- Country of Publication:
- United States
- Language:
- English
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550602 -- Medicine-- External Radiation in Diagnostics-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BLOOD FLOW
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
HOURS LIVING RADIOISOTOPES
IMAGES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MUSCLES
MYOCARDIAL INFARCTION
MYOCARDIUM
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
TECHNETIUM 99
TECHNETIUM ISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
YEARS LIVING RADIOISOTOPES