A nonischemic electrocardiogram does not always predict a small myocardial infarction: Results with acute myocardial perfusion imaging

Kontos, Michael C.; Kurdziel, Karen; Ornato, Joseph P.; Schmidt, Kristin L; Jesse, Robert L.; Tatum, James L.

doi:10.1067/mhj.2001.113079

Cited by 27 publications

(18 citation statements)

References 29 publications

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“…6 Even patients with a normal ECG my develop large infarctions. 5 The latter corresponds to our findings, as only 7 of 13 patients (54%) with infarct size Ն12% had any evidence of ischemia in the ECG.…”

Section: Infarct Size In Nstemi Patientsmentioning

confidence: 66%

“…As this and other studies show, a subgroup of NSTEMI patients have substantial infarction, 5,6 and there is a significant overlap in final infarct size between STEMI and NSTEMI patients. 6 Even patients with a normal ECG my develop large infarctions.…”

Section: Infarct Size In Nstemi Patientsmentioning

confidence: 76%

“…ST-segment elevation in the ECG has high specificity but suboptimal sensitivity for detection of MI and acute coronary occlusion 3 and has demonstrated only modest correlation to infarct size. 4 A number of patients with non-ST-segment-elevation MI (NSTEMI) have substantial infarction, 5,6 but these patients rarely fulfill criteria for acute reperfusion therapy. In current clinical practice, no instant method for early assessment of final infarct size in patients with NSTEMI exists.…”

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confidence: 99%

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Strain Echocardiography and Wall Motion Score Index Predicts Final Infarct Size in Patients With Non–ST-Segment–Elevation Myocardial Infarction

Eek

Grenne

Brunvand

et al. 2010

Circ: Cardiovascular Imaging

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Background-Infarct size is a strong predictor of mortality and major adverse cardiovascular events after myocardial infarction. Acute reperfusion therapy limits infarct size and improves survival, but its use has been confined to patients with ST-segment-elevation myocardial infarction. The purpose of this study was to assess the relationship between echocardiographic parameters of left ventricular (LV) systolic function obtained before revascularization and final infarct size in patients with non-ST-segment-elevation myocardial infarction, as well as the ability of these parameters to identify patients with substantial infarction. Methods and Results-Sixty-one patients with non-ST-segment-elevation myocardial infarction were examined by echocardiography immediately before revascularization, 2.1Ϯ0.6 days after hospitalization. LV systolic function was assessed by ejection fraction, wall motion score index, and circumferential, longitudinal, and radial strain in a 16-segment LV model. Global strain represents average segmental strain values. Infarct size was assessed after 9Ϯ3 months by late-enhancement MRI, as a percentage of total LV myocardial volume. A good correlation was found between infarct size and wall motion score index (rϭ0.74, PϽ0.001) and global longitudinal strain (rϭ0.68, PϽ0.001).Global longitudinal strain ϾϪ13.8% and wall motion score index Ͼ1.30 accurately identified patients with substantial infarction (Ն12% of myocardium, nϭ13; area under the receiver operator curve, 0.95 and 0.92, respectively). Conclusions-Echocardiographic

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Section: Infarct Size In Nstemi Patientsmentioning

confidence: 66%

Section: Infarct Size In Nstemi Patientsmentioning

confidence: 76%

mentioning

confidence: 99%

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Strain Echocardiography and Wall Motion Score Index Predicts Final Infarct Size in Patients With Non–ST-Segment–Elevation Myocardial Infarction

Eek

Grenne

Brunvand

et al. 2010

Circ: Cardiovascular Imaging

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show abstract

“…According to this, it has been repeatedly shown that some NSTEMI patients may have a substantial infarction [2,6,7]. Also, some authors showed a significant overlap in the final infarct size between STEMI and NSTEMI patients [7] and others documented that even NSTEMI patients with a normal ECG at presentation may develop large infarctions [6]. On this basis, NSTEMI patients who have a substantial infarction should be promptly identified.…”

Section: Discussionmentioning

confidence: 99%

Urgent Myocardial Revascularization in Non ST-Segment Elevation Acute Myocardial Infarction Guided by Speckle Tracking Echocardiography: A Challenging Interventional Decision-Making

et al. 2018

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A 68-year-old man with a non-ST elevation myocardial infarction (NSTEMI) presented with a low risk profile indicating invasive revascularization within 72 h. However, left ventricular (LV) global longitudinal strain (GLS) calculated by two-dimensional speckle tracking echocardiography (2D-STE) in the Emergency Room showed substantial myocardial infarction. Therefore, urgent reperfusion therapy was decided and delivered within 30 min from hospital admission. LV GLS fully recovered after the invasive procedure and the final infarct size was 7%. This case shows that very early revascularization in NSTEMI patients can be guided by 2D-STE and might be considered for those patients with substantial LV myocardial infarction.

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“…Em particular, a inversão de onda T pode ser observada, após dias ou semanas do procedimento cirúrgico, mesmo sem evidência de infarto após o procedimento e pode estar relacionada à pericardite (63) . (65)(66)(67) .…”

Section: Fisiologia Das Troponinasunclassified

Liberação de biomarcadores de necrose miocárdica após revascularização cirúrgica do miocárdio sem circulação extracorpórea, em ausência de infarto do miocárdio manifesto, avaliado pela ressonância magnética cardíaca

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A nonischemic electrocardiogram does not always predict a small myocardial infarction: Results with acute myocardial perfusion imaging

Cited by 27 publications

References 29 publications

Strain Echocardiography and Wall Motion Score Index Predicts Final Infarct Size in Patients With Non–ST-Segment–Elevation Myocardial Infarction

Strain Echocardiography and Wall Motion Score Index Predicts Final Infarct Size in Patients With Non–ST-Segment–Elevation Myocardial Infarction

Urgent Myocardial Revascularization in Non ST-Segment Elevation Acute Myocardial Infarction Guided by Speckle Tracking Echocardiography: A Challenging Interventional Decision-Making

Liberação de biomarcadores de necrose miocárdica após revascularização cirúrgica do miocárdio sem circulação extracorpórea, em ausência de infarto do miocárdio manifesto, avaliado pela ressonância magnética cardíaca

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