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

Gibson, Robert S.; Crampton, Richard S.; Watson, Denny D.; Taylor, George J.; Carabello, Blasé A.; Holt, Nina D.; Beller, George A.

doi:10.1161/01.cir.66.4.732

Cited by 163 publications

(28 citation statements)

References 30 publications

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“…However, no statistical significant mean age difference was found between two groups of patients (p>0.05). Similarly, another study 9 showed the mean age was found 50±8 years in group I and 53±5 years in group II, which is closely resembled with the current study.…”

Section: Discussionsupporting

confidence: 91%

“…9 In general, the 12-lead ECG is less sensitive in identifying left circumflex occlusion. Huey, et al, 1988 found that 52% of patients with acute MI from left circumflex disease did not show any ST segment elevation, while other investigators reported that acute left circumflex occlusion either does not bring about any changes at all in the standard 12-lead ECG 16 or generates only ST depression in the precordial leads (Jacobs, et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

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In-Hosptal Outcome and Angiographic Findings in Acute Inferior Myocardial Infarction with ST-Segment Elevation in Posterior Chest Leads ( V7, V8, V9 ) Following Thrombolytic Therapy

Haneef¹,

Majumder

Ali

et al. 2017

Bangladesh Heart J

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Conclusion: ST segment elevation in posterior chest leads (V 7 , V 8 , V 9 ) were associated with more in-hospital adverse outcome than those who had inferior MI alone. This group of patients had more PLVB involvement. Recording of posterior precordial leads appear to be beneficial for risk stratification and to locate the site of lesion in patients admitted with acute inferior myocardial infarction. Since it is inexpensive method, it may be used in any hospital.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

In-Hosptal Outcome and Angiographic Findings in Acute Inferior Myocardial Infarction with ST-Segment Elevation in Posterior Chest Leads ( V7, V8, V9 ) Following Thrombolytic Therapy

Haneef¹,

Majumder

Ali

et al. 2017

Bangladesh Heart J

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“…[1][2][3][4][5][6][7][8] As part of a study looking at partial-thickness ischemia in an experimental animal model, 9 we observed that ST depression accompanied some episodes of full-thickness ischemia and not others. The literature reflecting experimental infarction has shown that full-thickness ischemia was associated with a region of epicardial ST elevation over the ischemia with minimal changes elsewhere.…”

mentioning

confidence: 79%

Epicardial ST Depression in Acute Myocardial Infarction

Yong

et al. 1999

Circulation Research

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Abstract-The presence of electrocardiographic ST depression in acute infarction remains controversial and poorly explained. A combined animal and modeling study was performed to evaluate the source of ST changes in acute infarction. In anaesthetized sheep, small infarcts showed uniform ST elevation over the infarction whereas larger infarcts showed marked ST depression over the normal myocardium in addition to the ST elevation. These findings were replicated by bidomain models of the heart. A hollow sphere was used to model a gradually increasing infarct, and this showed that there was a decrease in the ratio of ST elevation to ST depression as the infarct was increased. The current flowing out of the heart must be identical to the current flowing back into the heart. This means that any infarction will produce ST depression as well as ST elevation, the ratio between the two being related to the size of the infarction. Small infarction is associated with a small region of ST elevation and minor ST depression of the remaining myocardium, and as the infarct region increases, the amplitude of the epicardial ST elevation falls and the amplitude of the ST depression increases. Infarction size is proportional to both the height of the ST depression on the epicardium and the strength of the epicardial ST segment dipole. (Circ Res. 1999;85:959-964.)Key Words: electrocardiography Ⅲ epicardial potential Ⅲ acute infarction Ⅲ bidomain model Ⅲ ST depression T he origins and significance of ST depression associated with acute myocardial infarction are poorly understood and controversial. [1][2][3][4][5][6][7][8] As part of a study looking at partial-thickness ischemia in an experimental animal model, 9 we observed that ST depression accompanied some episodes of full-thickness ischemia and not others. The literature reflecting experimental infarction has shown that full-thickness ischemia was associated with a region of epicardial ST elevation over the ischemia with minimal changes elsewhere. 10 -16 This discrepancy between clinical observation and experimental results has been more fully evaluated by detailed epicardial, endocardial, and body surface ECG mapping of acute infarction in different territories and of different sizes in an experimental sheep model. The electrical changes were correlated with regional blood flow measured by fluorescent microspheres. To explain the results of the experimental infarction, we have developed several levels of a bidomain model based on that described by Tung, 17 including a hollow thick-walled sphere, and a finite element model of the heart that replicated the experimental observations. Materials and Methods Experimental AnimalsA total of 33 sheep were randomized into three groups. Transmural ischemia was achieved by completely ligating the obtuse marginal branch (OM) in group 1, the proximal left circumflex coronary artery (LCX) in group 2, and the proximal left anterior descending coronary artery (LAD) in group 3 for a minimum of 20 minutes. The epicardial ST potential fields were re...

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“…For each patient autologous leucocytes labelled with "'In were prepared using "'In-hydroxyquinoline (oxine) solution (Amersham International IN 15P), the labelling dose being in the range [10][11][12][13][14][15][16][17][18][19][20] MBq (270-540 1iCi). A mean labelling efficiency of 78.50% (range 62-95") was achieved for all patients studied.…”

Section: Methodsmentioning

confidence: 99%

“…To examine this possibility 103 consecutive patients who underwent exercise testing early after myocardial infarction were reviewed. Treadmill exercise testing was performed a mean of 12 (range 5-30) days after infarction using a limited Naughton protocol. Resting electrocardiograms were independently reviewed by two observers (KJ and DSR), and equivocal ST changes were referred 635 to a third party for arbitration (DGJ).…”

Section: Jennings Douglas S Reid Desmond G Julian Abstractmentioning

confidence: 99%

"Reciprocal" depression of the ST segment in acute myocardial infarction.

Jennings¹,

Reid²,

Julian³

1983

BMJ

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

Abstract: SUMMARY The cause and associated pathophysiology of precordial ST-segment depression (ST {) during acute inferior myocardial infarction (IMI)

Cited by 163 publications

References 30 publications

In-Hosptal Outcome and Angiographic Findings in Acute Inferior Myocardial Infarction with ST-Segment Elevation in Posterior Chest Leads ( V7, V8, V9 ) Following Thrombolytic Therapy

In-Hosptal Outcome and Angiographic Findings in Acute Inferior Myocardial Infarction with ST-Segment Elevation in Posterior Chest Leads ( V7, V8, V9 ) Following Thrombolytic Therapy

Epicardial ST Depression in Acute Myocardial Infarction

"Reciprocal" depression of the ST segment in acute myocardial infarction.

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