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Article: Value of ST-segment depression in lead V 4R in predicting proximal against distal left circumflex artery occlusion in acute inferoposterior myocardial infarction

TitleValue of ST-segment depression in lead V 4R in predicting proximal against distal left circumflex artery occlusion in acute inferoposterior myocardial infarction
Authors
Issue Date2007
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
Citation
Clinical Cardiology, 2007, v. 30 n. 1, p. 36-41 How to Cite?
AbstractBackground: Lead V 4R faces the right ventricular free wall; it also reflects ischemia in the posterolateral wall lying opposite and manifests as ST-segment depression. Hypothesis: The aim of this study was to evaluate the usefulness of V 4R ST-segment depression in distinguishing proximal from distal left circumflex artery occlusion in acute inferoposterior wall myocardial infarction. Methods: We retrospectively analyzed 239 patients who had first acute inferoposterior myocardial infarction, were admitted within 6 h from onset of symptom, and had coronary angiography performed within 4 weeks. Patients who had bundle-branch block or concomitant significant stenoses in the proximal and distal segments of the same vessel or of both vessels were excluded. The electrocardiographic and angiographic findings were reviewed by two independent groups of investigators. Results: V 4R ST-segment depression ≥1.0 mm was found in 8 of 46 patients (17.4%) with left circumflex artery occlusion but none (0%) with right coronary artery occlusion. Among the group with left circumflex artery occlusion, the mean magnitude of V 4R ST-segment depression was greater in proximal than distal occlusion (0.82 ± 0.65 vs. 0.03 ± 0.12 mm, p < 0.0001). V 4R ST-segment depression ≥1.0 mm was found in 8 of 14 patients (57.1%) with proximal occlusion but none (0%) in 32 patients with distal occlusion. The sensitivity and specificity to predict proximal occlusion were 57.1 and 100%, respectively. Conclusions: V 4R ST-segment depression ≥1.0 mm was not useful for differentiating left circumflex and right coronary artery occlusion because of its low sensitivity. It is a fairly sensitive and very specific sign of proximal left circumflex artery occlusion. © 2007 Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/163056
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.authorHo, HHen_US
dc.contributor.authorSiu, CWen_US
dc.contributor.authorMiu, Ren_US
dc.contributor.authorChan, CWSen_US
dc.contributor.authorLee, SWLen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:27:01Z-
dc.date.available2012-09-05T05:27:01Z-
dc.date.issued2007en_US
dc.identifier.citationClinical Cardiology, 2007, v. 30 n. 1, p. 36-41en_US
dc.identifier.issn0160-9289en_US
dc.identifier.urihttp://hdl.handle.net/10722/163056-
dc.description.abstractBackground: Lead V 4R faces the right ventricular free wall; it also reflects ischemia in the posterolateral wall lying opposite and manifests as ST-segment depression. Hypothesis: The aim of this study was to evaluate the usefulness of V 4R ST-segment depression in distinguishing proximal from distal left circumflex artery occlusion in acute inferoposterior wall myocardial infarction. Methods: We retrospectively analyzed 239 patients who had first acute inferoposterior myocardial infarction, were admitted within 6 h from onset of symptom, and had coronary angiography performed within 4 weeks. Patients who had bundle-branch block or concomitant significant stenoses in the proximal and distal segments of the same vessel or of both vessels were excluded. The electrocardiographic and angiographic findings were reviewed by two independent groups of investigators. Results: V 4R ST-segment depression ≥1.0 mm was found in 8 of 46 patients (17.4%) with left circumflex artery occlusion but none (0%) with right coronary artery occlusion. Among the group with left circumflex artery occlusion, the mean magnitude of V 4R ST-segment depression was greater in proximal than distal occlusion (0.82 ± 0.65 vs. 0.03 ± 0.12 mm, p < 0.0001). V 4R ST-segment depression ≥1.0 mm was found in 8 of 14 patients (57.1%) with proximal occlusion but none (0%) in 32 patients with distal occlusion. The sensitivity and specificity to predict proximal occlusion were 57.1 and 100%, respectively. Conclusions: V 4R ST-segment depression ≥1.0 mm was not useful for differentiating left circumflex and right coronary artery occlusion because of its low sensitivity. It is a fairly sensitive and very specific sign of proximal left circumflex artery occlusion. © 2007 Wiley Periodicals, Inc.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.meshCoronary Angiographyen_US
dc.subject.meshCoronary Disease - Diagnosis - Etiologyen_US
dc.subject.meshElectrocardiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMyocardial Infarction - Physiopathologyen_US
dc.subject.meshPredictive Value Of Testsen_US
dc.titleValue of ST-segment depression in lead V 4R in predicting proximal against distal left circumflex artery occlusion in acute inferoposterior 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.4en_US
dc.identifier.pmid17262766-
dc.identifier.scopuseid_2-s2.0-33846439403en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33846439403&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume30en_US
dc.identifier.issue1en_US
dc.identifier.spage36en_US
dc.identifier.epage41en_US
dc.identifier.isiWOS:000243674500006-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridJim, MH=6603860344en_US
dc.identifier.scopusauthoridHo, HH=7401465369en_US
dc.identifier.scopusauthoridSiu, CW=7006550690en_US
dc.identifier.scopusauthoridMiu, R=7801613455en_US
dc.identifier.scopusauthoridChan, CWS=7404813871en_US
dc.identifier.scopusauthoridLee, SWL=23990967700en_US
dc.identifier.scopusauthoridLau, CP=35275317200en_US

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