This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lembo, N. J. Articles by O'Rourke, R. A. Search for Related Content PubMed PubMed Citation Articles by Lembo, N. J. Articles by O'Rourke, R. A.

Circulation, Vol 74, 56-63, Copyright © 1986 by American Heart Association

ARTICLES

Clinical and prognostic importance of persistent precordial (V1-V4) electrocardiographic ST segment depression in patients with inferior transmural myocardial infarction

NJ Lembo, MR Starling, LJ Dell'Italia, MH Crawford, TK Chaudhuri and RA O'Rourke

Forty-three consecutive patients with acute inferior transmural myocardial infarction but no history or electrocardiographic evidence of prior myocardial infarction were evaluated prospectively to assess the clinical and prognostic importance of persistent precordial (V1-V4) ST segment depression. Patients were evaluated within 24 hr of admission by history, physical examination, cardiac enzyme levels, right heart catheterization, and radionuclide angiography; all were followed for 1 year. Ten of the 43 patients (group I) had persistent anterior precordial ST segment depression, defined as 1 mm or greater in one or more precordial leads (V1-V4) 24 hr after admission to the coronary care unit, and 33 patients (group II) did not. Clinical variables that differed between groups I and II, respectively, included mean age (67 +/- 9 [+/- 1 SD] vs 59 +/- 8 years; p less than .01), incidence of Killip class II to IV (100% vs 33%; p less than .001), and average peak creatine kinase concentration (2878 +/- 1139 vs 1511 +/- 1034 IU/liter; p less than .001). Hemodynamic differences between groups I and II included a higher pulmonary arterial wedge pressure (19 +/- 4 vs 11 +/- 5 mm Hg; p less than .001) and a lower cardiac index (2.0 +/- 0.5 vs 2.6 +/- 0.7 liters/min/m2; p less than .05). An evaluation of left ventricular ejection fraction and wall motion index by radionuclide angiography showed that group I had a lower ejection fraction (44 +/- 11% vs 53 +/- 10%; p less than .05) and higher wall motion index (1.7 +/- 0.4 vs 1.4 +/- 0.3; p less than .05) compared with group II.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				M. C. Tjandrawidjaja, Y. Fu, C. M. Westerhout, H. D. White, T. G. Todaro, F. Van de Werf, K. W. Mahaffey, G. S. Wagner, C. B. Granger, P. W. Armstrong, et al. Resolution of ST-segment depression: a new prognostic marker in ST-segment elevation myocardial infarction Eur. Heart J., December 1, 2009; (2009) ehp494v1. [Abstract] [Full Text] [PDF]

				R. Nijveldt, P. A. van der Vleuten, A. Hirsch, A. M. Beek, R. A. Tio, J. G.P. Tijssen, J. J. Piek, A. C. van Rossum, and F. Zijlstra Early Electrocardiographic Findings and MR Imaging-Verified Microvascular Injury and Myocardial Infarct Size J. Am. Coll. Cardiol. Img., October 1, 2009; 2(10): 1187 - 1194. [Abstract] [Full Text] [PDF]

				W. J Brady and F. Morris Electrocardiographic abnormalities encountered in acute myocardial infarction Emerg. Med. J., January 1, 2000; 17(1): 40 - 45. [Full Text] [PDF]

				M. C. Borgia, F. Gori, A. Pellicelli, D. Curcio, M. Lionetti, P. A. Buccarella, and M. Lucidi Influence of Thrombolytic Therapy on Inferior Acute Myocardial Infarction with Concomitant Anterior ST Segment Depression Angiology, August 1, 1999; 50(8): 619 - 628. [Abstract] [PDF]

				M. Zehender, W. Kasper, E. Kauder, M. Schonthaler, A. Geibel, M. Olschewski, and H. Just Right Ventricular Infarction as an Independent Predictor of Prognosis after Acute Inferior Myocardial Infarction N. Engl. J. Med., April 8, 1993; 328(14): 981 - 988. [Abstract] [Full Text]