Relationships between cardiac magnetic resonance imaging abnormalities in the inter-ventricular septum and Selvester QRS scoring criteria for anterior–septal myocardial infarction in patients with right ventricular volume overload

Siddiqui, Adeel; Zainab, Samad; Crowley, Anna Lisa; Hakacova, Nina; Harrison, J. Kevin; Wagner, Galen S.

doi:10.1016/j.jelectrocard.2013.02.010

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…These data were confirmed in a study of patients with pulmonary hypertension [29]. In addition, Sidiqui et al [30] showed that in the population with chronic right ventricle volume overload caused by atrial septal defect, LGE was very infrequent and occurred in only 1 out of 46 patients (2%). This finding is consistent with our observation.…”

Section: Discussionmentioning

confidence: 68%

Clinical aspects of myocardial fibrosis in adults with Ebstein’s anomaly

et al. 2018

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Heart failure and arrhythmia are common complications in adults with Ebstein’s anomaly. They may result not only from hemodynamic alterations, but also from myocardial fibrosis. Late gadolinium enhancement (LGE) by CMR enables the evaluation of myocardial fibrosis. The aim of the study was to asses the presence of LGE and its relation to clinical outcome. We studied a group of 37 unoperated adults aged 43.0 ± 14.4 years with Ebstein’s anomaly from the congenital heart disease outpatient clinic. Study protocol included: cardiopulmonary test, assessment of supraventricular arrhythmia (SVA), and CMR with evaluation of cardiac chambers’ morphology and function, and presence of LGE. Variables following normal distribution were shown as mean ± SD if otherwise median (range) was applied. Fibrosis was found in 18 patients (48.6%) and was distributed as follows: 12 patients (32.4%) in the right atrium, 12 (32.4%) in the atrialized right ventricle, and 2 (5.4%) in the functional right ventricle. In patients with fibrosis, the tricuspid regurgitation fraction was bigger (48.3 ± 19.7 vs. 36.1 ± 22.6%, p = 0.048) and SVA was more frequent [12 (66.7%) vs. 6 (31.6%), p = 0.046] when compared to patients without fibrosis. However, exercise capacity did not differ between patients with and without LGE (peak VO2 24.0 ± 4.7 vs. 23.7 ± 4.4, p = 0.87). In adults with Ebstein’s anomaly fibrosis estimated by LGE-CMR was localized in the right atrium and the right ventricle only. Volume overload resulting from tricuspid regurgitation might be a factor conducive to fibrosis. Myocardial fibrosis did not influence exercise capacity. Association between myocardial fibrosis and supraventricular arrhythmia was confirmed.

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Section: Discussionmentioning

confidence: 68%

Clinical aspects of myocardial fibrosis in adults with Ebstein’s anomaly

et al. 2018

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“…A complicating factor in the diagnosis of OMI is that a random ECG may not always give indications of OMI. A study regarding infarctions in the septum, showed that the Selvester QRS points system indicated a 52 % prevalence in anteroseptal scarring, but only one of 46 patients involved, had septal scarring [24]. Random ECG is dif icult to use in the diagnosis of UMI, as Q-waves have poor predictive value of localisation of MI in all parts of the heart, except the anterior wall, where one inds a scar in 89% of all Q-waves [25].…”

Section: Discussionmentioning

confidence: 99%

Unrecognized myocardial infarction in the elderly

Morild¹

2017

J Forensic Sci Res

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This study presents the frequency of old myocardial infarctions (OMI), and the frequency of unrecognized myocardial infarction (UMI) in elderly people in a forensic material. It was also examined if predisposing factors of UMI could be identifi ed. Of special interest was also to investigate the value of the police's records as a source for medical information in a forensic setting. The study is based upon medico-legal autopsies of persons above the age of 60 at the time of death during the period 1999-2003. The study included 325 cardiovascular deaths. Of these, 166 died from OMI. UMI accounted for 123 of these (74%). Most UMI were located in the interventricular myocardial septum and left anterior wall (>60%), but no signifi cant differences could be found between UMI and recognized MIs (RMI). No obvious reason could be found as to why the UMI remained unrecognized. Police records were inferior to the hospitals records, regarding medical information to the pathologist, with information about cardiac disease in about 60%, and with information about OMI in 11-17%. Hospital records supplying information about OMI were found in half the cases. It is concluded that unrecognized myocardial infarction is not uncommon among elderly persons, and with a high risk of sudden death. More emphasis should be put in recognizing OMI in ECGs to attempt to reduce the risk of sudden cardiac death.

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“…Among the CVDs are ischemic heart diseases, high blood pressure, coronary heart disease, congestive heart failure, acute myocardial infarction, stroke, etc., and raised blood pressure is responsible for 7.6 million deaths per annum worldwide [1]. Myocardial infarction is one of the most alarming CVDs, which is a clinical syndrome arising from sudden and persistent curtailment of myocardial blood supply that results in the necrosis of the myocardium [2]. This is usually followed by numerous pathophysiological and biochemical changes including lipid peroxidation (LPO) and hyperlipidemia [3].…”

Section: Introductionmentioning

confidence: 99%