当前位置： SCI文献检索 > JOURNAL OF ELECTROCARDIOLOGY期刊下所有文献 > The predictive value of aVR in determining the infarct related artery during primary percutaneous coronary intervention.

The predictive value of aVR in determining the infarct related artery during primary percutaneous coronary intervention.

Abstract：

BACKGROUND:Isolation of infract related artery and timely revascularisation remains vital in the setting of primary percutaneous coronary intervention. OBJECTIVES:To analyse the predictive value of ST-T changes in lead aVR in inferior myocardial infarction in terms of prognosis and timely risk stratification. METHODS:We conducted a prospective analysis of acute inferior wall myocardial infarction patients. One hundred patients were categorised into two groups according to the culprit artery: group I, right coronary artery (RCA) and group II, left circumflex coronary artery (LCX), with 50 patients in each group. A comparative study was performed between the two groups, comprising the following data outputs: electrocardiogram (ECG) changes that could help determine the culprit artery, cardiac enzyme levels, echocardiographic findings, coronary angiography findings and in-hospital complications. The same patients were divided into two groups according to the presence or absence of 1 mm ST depression in lead aVR. A comparison analysis was performed between the two groups including: cardiac enzyme levels, echocardiographic findings, coronary angiography findings and in-hospital complications. RESULTS:ST depression in aVR ≥ 1 mm predicted the LCX as a culprit artery with sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) recorded at 66%, 84%, 80.5% and 71.2%, respectively. Also, patients with ST depression in aVR ≥ 1 mm showed significantly higher cardiac enzyme levels, indicating larger infarct size, with mean peak creatinine kinase (CK) = 1560 (1057-2375) IU/L versus 970 (613-1683) IU/L, (P value = 0.014), lower ejection fraction (Ef) with mean Ef = 47.93 ± 8.04 versus 54.66 ± 6.52, (P value < 0.001) and more significant mitral regurgitation: 17 (41.5%) patients versus 11 (18.6%) patients (P value = 0.012). Regarding in-hospital complications, there were no significant differences. CONCLUSIONS:ST depression of >1 mm in lead aVR predicts LCX as the infarct related artery and is a predictor of poor outcome in patients with inferior myocardial infarction.

journal_name

J Electrocardiol

journal_title

Journal of electrocardiology

authors

Gaballa A,Farid W,Al-Kersh A,Rajan R,Al Jarallah M

doi

10.1016/j.jelectrocard.2018.10.094

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

59-62

eissn

0022-0736

issn

1532-8430

pii

S0022-0736(18)30453-9

journal_volume

pub_type

杂志文章

在线工具

The predictive value of aVR in determining the infarct related artery during primary percutaneous coronary intervention.