Correlation between the Admission Electrocardiogram and Regional Wall Motion Abnormalities As Detected by Echocardiography in Anterior Acute Myocardial Infarction

Abstract

We correlated ST elevation in various leads on admission and regional dysfunction in 132 patient with first anterior acute myocardial infarction using echocardiography. ST elevation in leads I and a VL and II, III and aVF was not associated with a specific pattern of regional dysfunction. Basal anterior and septal regional dysfunction were seen more often in patients with ST elevation in V1 (49 vs. 25%, p = 0.006; 35 vs. 17%, p = 0.048, respectively). Patients with ST elevation in V2 had more regional dysfunction of the apical inferior region (84 vs. 53%; p = 0.01). ST elevation in V5 and V6 was not associated with more apical or lateral wall motion abnormalities. ST elevation in lead V1 in anterior myocardial infarction is associated with a high incidence of regional dysfunction of the basal anterior, anteroseptal and septal regions.

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

“…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.…”

“…The same was found by some other researchers. 6 In the present study, mean (± SD) number of total involved segments in group I and group II patients were 8.83 (±2.49) and 9.01 (±2.25) respectively with no statistically significant difference. This finding was supported by Bandeali et al 4 where mean number of total involved segments were 6.5 (±4) and 8 (±4.5) in AS-STEMI and EA-STEMI groups respectively with no statistically significant difference.…”

“…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.…”

“…3 Shalev et al 5 suggested that, only the anteriorseptum is never exclusively affected in patients with AS-STEMI. Porter et al 6 showed that STE in lead V1 and lead V2 is associated with different areas of infarction rather than septum. Bogaty et al 7 suggested that AS-STEMI is associated with an area of infarction predominantly involving the apex.…”

“…However neither angiographic nor echocardiographic data has correlated with either injury pattern with the expected location of injury. [5][6][7]9 Two explanations regarding this matter opposing each other have been given; i.e. AS-STEMI is associated with a relatively small area of infarction, or it may be a manifestation of a large area of infarction, caused by a proximal occlusion of a wrapping left anterior descending artery (LAD) where STE in inferolateral leads (leads V4 to V6) is cancelled by an opposing injury vector involving the basal segments, i.e.…”