Precordial ST-segment depression during acute inferior myocardial infarction: clinical, scintigraphic and angiographic correlations

Conference · Fri Oct 01 00:00:00 EDT 1982 · Circulation; (United States)

OSTI ID:6432531

Gibson, R S; Crampton, R S; Watson, D D; Taylor, G J; Carabello, B A; Holt, N D; Beller, G A

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), Vol. 66:4; Conference: 54th Annual Scientific Sessions of the American Heart Association, Dallas, TX, Nov 1981
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
MYOCARDIAL INFARCTION
DIAGNOSIS
MYOCARDIUM
BIOMEDICAL RADIOGRAPHY
SCINTISCANNING
BLOOD FLOW
BLOOD VESSELS
IMAGES
ISOMERIC NUCLEI
PATIENTS
TECHNETIUM 99
THALLIUM 201
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CARDIOVASCULAR SYSTEM
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ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MUSCLES
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
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RADIOLOGY
SECONDS LIVING RADIOISOTOPES
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