Comparison of segmental wall motion abnormalities on echocardiography in patients with anteroseptal versus extensive anterior wall ST-segment elevation myocardial infarction

Bandeali, Salman; Stone, Sabrina; Huang, Henry; Kayani, Waleed T.; Wilson, James M.; Birnbaum, Yochai

doi:10.1016/j.jelectrocard.2012.07.001

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…But, as a whole, no significant difference was observed regarding the prevalence of smoking, hypertension, dyslipidaemia, sedentary life style and obesity between the groups, as was observed by Huang et al 9 The results of our study showed that there was no significant difference in global wall motion abnormality as assessed by measuring ejection fraction between patients with AS-STEMI and EA-STEMI. Our finding is consistent with Bandeali et al 4 who reported mean (±SD) EF% was 39.17% (±10.5) vs. 44.08% (±10.5) with p>0.05. The same was found by some other researchers.…”

Section: Discussionsupporting

confidence: 93%

“…Age distribution in both groups in our study was similar to Bandeali et al 4 , Porter et al 6 , Huang et al 9 , Zafrir et al 14 and similarity in gender distribution was also found between our study and several other similar studies. 4,6,9 Comparison of traditional risk factors revealed that AS-STEMI group had significantly more patients with diabetes mellitus and family history of CAD was significantly more prevalent in EA-STEMI patients.…”

Section: Discussionsupporting

confidence: 91%

“…4,6,9 Comparison of traditional risk factors revealed that AS-STEMI group had significantly more patients with diabetes mellitus and family history of CAD was significantly more prevalent in EA-STEMI patients. But, as a whole, no significant difference was observed regarding the prevalence of smoking, hypertension, dyslipidaemia, sedentary life style and obesity between the groups, as was observed by Huang et al 9 The results of our study showed that there was no significant difference in global wall motion abnormality as assessed by measuring ejection fraction between patients with AS-STEMI and EA-STEMI.…”

Section: Discussionmentioning

confidence: 99%

“…But the apex may be involved either in anteroseptal, extensive anterior, or left dominant system occlusion related inferolateral MI. Bandeali et al 4 showed that AS-STEMI causes similar area of left ventricular involvement as that in EA-STEMI. Aldrich et al 8 suggested that the number of leads with ST segment elevation correlates with the infarct size in patients with A-STEMI, implying that AS-STEMI is associated with an infarct size smaller than that in patients with EA-STEMI.…”

Section: Introductionmentioning

confidence: 96%

“…It can be commonly classified as anteroseptal STEMI and extensive anterior STEMI. [2][3][4] Conventionally, ECG leads are said to be oriented according to the anatomic zones of the left ventricle i.e. V1-V3 for anteroseptal zone, V4-V6 for apical or lateral zone, I and aVL for high lateral zone.…”

Section: Introductionmentioning

confidence: 99%

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Echocardiographic comparison of regional wall motion abnormality between patients with acute anteroseptal and acute extensive anteior ST segment elevation myocardial infarction

Khan¹,

Chowdhury

Khan³

et al. 2016

Bangladesh Med Res Counc Bull

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Post myocardial infarction (MI) short and long term clinical outcome is largely determined by the size of the infarcted area. It is generally assumed that as the lead involvement in electrocardiography (ECG) is less in anteroseptal ST segment elevation myocardial infarction (AS-STEMI), where ST segment elevation (STE) is limited to leads V1 to V3, myocardial damage is likely to be less; and in extensive anterior STEMI (EA-STEMI), as the STE extends further upto V6, the myocardial damage is likely to be more. This study was intended to compare regional wall motion abnormality (RWMA) between acute anteroseptal STEMI and acute extensive anterior STEMI patients. 90 patients with AS-STEMI and 106 patients with EA-STEMI, admitted in between October 2012 and September 2013, were included. For each patient, a transthoracic echocardiogram (TTE) was performed within 24-48 hours of MI and was interpreted by an independent investigator blinded to the patient's ECG data. No differences were observed between the two groups in baseline characteristics; except AS-STEMI group had more patients with diabetes and EA-STEMI group had more patients with family history of coronary artery disease. Distribution, extent of wall motion abnormalities and mean number of total involved segments were similar between patients with AS-STEMI and those with EA-STEMI (p>0.05). Regarding regional dysfunction, the apical septal (99.1% vs. 92.2%, p<0.05) and apical (76.4% vs. 60.0%, p<0.05) segments were the only two segments that were affected significantly more in patients with EA-STEMI than in patients with AS-STEMI. So, the term AS-STEMI may be a misnomer, as it implies that only the anteroseptal segments of the left ventricle are involved. This study shows that regional dysfunction in patients with AS-STEMI extends beyond the anteroseptal region. So, any patients with anterior wall involvement, either anteroseptal or extensive anterior STEMI, should be treated with equal importance.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Echocardiographic comparison of regional wall motion abnormality between patients with acute anteroseptal and acute extensive anteior ST segment elevation myocardial infarction

Khan¹,

Chowdhury

Khan³

et al. 2016

Bangladesh Med Res Counc Bull

View full text Add to dashboard Cite

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References

2019

Electrocardiography in Ischemic Heart Disease

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The Electrocardiogram in Coronary Artery Disease

Birnbaum

Wilson

Nikus

2015

Coronary Artery Disease

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The fi rst human electrocardiogram (ECG) was performed by AD Waller in 1887. Willem Einthoven was the fi rst one to use the term ECG in 1901 and named the waves P, Q, R, S and T. The ECG remains a major non-invasive cardiac imaging tool. In the last 30 years newer and more direct imaging modalities, such as echocardiography, nuclear scanning, cardiac computerized tomography (CT) and magnetic resonance imaging (MRI) have been developed, adding to the information gained from the ECG in the assessment of the heart in various stable conditions. Yet, due to its wide availability, low-cost and rapid interpretation, the ECG remains the most commonly used and, perhaps most important of available cardiovascular diagnostic tools; especially for rapid assessment of patients with symptoms compatible with acute coronary syndromes (ACS) and/or arrhythmia. The Electrocardiogram in Coronary AbstractThe electrocardiogram (ECG) remains the most commonly used and, perhaps most important of available cardiovascular diagnostic tools; especially for rapid assessment of patients with symptoms compatible with acute coronary syndromes (ACS) and/or arrhythmia. ST elevation is thought to represent transmural ischemia due to thrombotic occlusion of an epicardial artery. Emergent reperfusion therapy by primary percutaneous intervention (PCI) or thrombolytic therapy is usually indicated. In contrast, patients without ST segment elevation are treated conservatively in the initial stages. However, the distinction between ST elevation myocardial infarction (STEMI) and non ST elevation ACS (NSTE-ACS) is not always clear. Many patients with compatible symptoms have ST elevation not due to "transmural ischemia". On the other hand, occasionally, patients may have acute ischemia due to complete occlusion of an epicardial artery, but their ECG may show minor degree of ST elevation. Moreover, certain distinct ECG patterns have been described in patients presenting without ST elevation that are associated with higher risk. Recognition of these specifi c patterns of NSTE-ACS, as well as common patterns suggesting non-ischemic ST elevation is crucial.

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Comparison of segmental wall motion abnormalities on echocardiography in patients with anteroseptal versus extensive anterior wall ST-segment elevation myocardial infarction

Cited by 7 publications

References 18 publications

Echocardiographic comparison of regional wall motion abnormality between patients with acute anteroseptal and acute extensive anteior ST segment elevation myocardial infarction

Echocardiographic comparison of regional wall motion abnormality between patients with acute anteroseptal and acute extensive anteior ST segment elevation myocardial infarction

References

The Electrocardiogram in Coronary Artery Disease

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