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Article: Prognostic implications of PR-segment depression in inferior leads in acute inferior myocardial infarction

TitlePrognostic implications of PR-segment depression in inferior leads in acute inferior myocardial infarction
Authors
Issue Date2006
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
Citation
Clinical Cardiology, 2006, v. 29 n. 8, p. 363-368 How to Cite?
AbstractBackground: Concurrent atrial ischemia is usually overlooked in acute myocardial infarction (MI) due to its subtle electrocardiographic (ECG) changes, lack of clear-cut clinical picture, and prognostic significance. PR-segment depression in the inferior leads is a simplified ECG sign for detecting possible underlying atrial ischemia. Hypothesis: The purpose of this study was to document the incidence, clinical characteristics, and prognostic implications of this ECG sign in the setting of acute inferior MI. Methods: Demographics, clinical characteristics, and outcomes of 463 consecutive patients presenting with acute inferior MI were reviewed. The in-hospital ECG was examined by two independent reviewers. The results were then compared between those with and without ECG sign. Results: Profound PR-segment depression ≥ 1.2 mm in inferior leads was found in 9 of 463 (1.9%) patients. Patients with atrial ischemia tended to present earlier (2.4 ± 2.6 vs. 7.0 ± 8.2 h, p = 0.000) and had a higher frequency of first-degree atrioventricular block (77.8 vs. 30.6%, p = 0.028) and supraventricular arrhythmias (55.5 vs. 20.2%, p = 0.022). Of greater importance, it was significantly associated with an increased rate of cardiac free-wall rupture (33.3 vs. 2.0%, p = 0.001) and in-hospital mortality (44.4 vs. 11.7%, p = 0.015). Conclusion: Profound PR-segment depression ≥ 1.2 mm in inferior leads was associated with a complicated hospital course and poor short-term outcome in acute inferior MI. These patients were at high risk for the development of atrioventricular block, supraventricular arrhythmias, and cardiac free-wall rupture.
Persistent Identifierhttp://hdl.handle.net/10722/163012
ISSN
2015 Impact Factor: 2.431
2015 SCImago Journal Rankings: 1.309
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorJim, MHen_US
dc.contributor.authorSiu, CWen_US
dc.contributor.authorChan, AOOen_US
dc.contributor.authorChan, RHWen_US
dc.contributor.authorLee, SWLen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:26:31Z-
dc.date.available2012-09-05T05:26:31Z-
dc.date.issued2006en_US
dc.identifier.citationClinical Cardiology, 2006, v. 29 n. 8, p. 363-368en_US
dc.identifier.issn0160-9289en_US
dc.identifier.urihttp://hdl.handle.net/10722/163012-
dc.description.abstractBackground: Concurrent atrial ischemia is usually overlooked in acute myocardial infarction (MI) due to its subtle electrocardiographic (ECG) changes, lack of clear-cut clinical picture, and prognostic significance. PR-segment depression in the inferior leads is a simplified ECG sign for detecting possible underlying atrial ischemia. Hypothesis: The purpose of this study was to document the incidence, clinical characteristics, and prognostic implications of this ECG sign in the setting of acute inferior MI. Methods: Demographics, clinical characteristics, and outcomes of 463 consecutive patients presenting with acute inferior MI were reviewed. The in-hospital ECG was examined by two independent reviewers. The results were then compared between those with and without ECG sign. Results: Profound PR-segment depression ≥ 1.2 mm in inferior leads was found in 9 of 463 (1.9%) patients. Patients with atrial ischemia tended to present earlier (2.4 ± 2.6 vs. 7.0 ± 8.2 h, p = 0.000) and had a higher frequency of first-degree atrioventricular block (77.8 vs. 30.6%, p = 0.028) and supraventricular arrhythmias (55.5 vs. 20.2%, p = 0.022). Of greater importance, it was significantly associated with an increased rate of cardiac free-wall rupture (33.3 vs. 2.0%, p = 0.001) and in-hospital mortality (44.4 vs. 11.7%, p = 0.015). Conclusion: Profound PR-segment depression ≥ 1.2 mm in inferior leads was associated with a complicated hospital course and poor short-term outcome in acute inferior MI. These patients were at high risk for the development of atrioventricular block, supraventricular arrhythmias, and cardiac free-wall rupture.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.orgen_US
dc.relation.ispartofClinical Cardiologyen_US
dc.subject.meshAgeden_US
dc.subject.meshCase-Control Studiesen_US
dc.subject.meshElectrocardiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Atria - Physiopathologyen_US
dc.subject.meshHeart Conduction System - Physiopathologyen_US
dc.subject.meshHeart Rupture - Mortality - Physiopathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMyocardial Infarction - Mortality - Physiopathologyen_US
dc.subject.meshPrognosisen_US
dc.titlePrognostic implications of PR-segment depression in inferior leads in acute inferior myocardial infarctionen_US
dc.typeArticleen_US
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_US
dc.identifier.authoritySiu, CW=rp00534en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/clc.4960290809-
dc.identifier.pmid16933578-
dc.identifier.scopuseid_2-s2.0-33747621650en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33747621650&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume29en_US
dc.identifier.issue8en_US
dc.identifier.spage363en_US
dc.identifier.epage368en_US
dc.identifier.isiWOS:000239480900009-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridJim, MH=6603860344en_US
dc.identifier.scopusauthoridSiu, CW=7006550690en_US
dc.identifier.scopusauthoridChan, AOO=7403167965en_US
dc.identifier.scopusauthoridChan, RHW=7403110832en_US
dc.identifier.scopusauthoridLee, SWL=23990967700en_US
dc.identifier.scopusauthoridLau, CP=35275317200en_US

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