You are here

Home » Content

Akut İnferior Miyokard İnfarktüsünde Sorumlu Arterin Öngörülmesinde Yeni EKG Kriterleri

New Electrocardiographic Criteria for Predicting Culprit Coronary Artery in Inferior Wall Acute Myocardial Infarction

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2004

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Ischemic heart disease is an important cause of morbidity and mortality and 99% of the cases are caused by coronary atherosclerosis. Predicting the culprit coronary artery in inferior wall acute myocardial infarction by surface ECG has been assessed in numerous studies, in which ECG criteria have been used either one by one or together, however the ideal criteria have not been defined. In this trial we aimed to predict the culprit coronary artery in the early stage in inferior wall acute myocardial infarction by using surface ECG. The two criteria, which can be used pratically, was studied one by one and together. These criteria included A) ST elevation at DIII > ST elevation at DII and B) ST depression at aVL > ST depression at DI. Forty-one patients with inferior myocardial infarction have been included in the trial. Fischer chi-square test was used as the istatistical analysis. Although the sensitivity or spesifisity of the criteria A or B in assessing the right coronary artery lesion was not high, using both criteria together showed high specifity. In conclusion, our study showed that the culprit artery in acute inferior myocardial infarction could be predicted by using ECG criteria. Early and right determination of the culprit infarct artery enables us to assess the myocardial area under risk, to estimate the clinical risk and to get ready for an urgent revascularization.
Bookmark/Search this post with
Abstract (Original Language): 
İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık %99 olguda koroner ateroskleroza bağlıdır. Akut miyokard infarktüsünde yüzey EKG ile sorumlu arterin tespiti birçok çalışmada araştırılmış, EKG kriterleri tek tek ve kombine olarak çalışılmış, fakat ideal kriter veya kriterler tanımlanamamıştır. Biz bu çalışmada akut inferior miyokard infaktüsünde yüzey EKG’sini kullanarak erken dönemde infarktüsten sorumlu arteri tespit etmeyi amaçladık. Pratik olarak kullanılabilecek 2 kriter tek tek ve kombine olarak değerlendirildi. Bu kriterler şöyle idi: A) DIII’te ST elevasyonu > DII’de ST elevasyonu ise ve B) aVL’de ST depresyonu > DI’de ST depresyonu. Çalışmaya 41 akut inferior miyokard infarktüslü hasta dahil edildi. Kriter A ve kriter B’nin sağ koroner arter lezyonunu belirlemedeki sensitivite ve spesifisitesi yüksek saptanmasada her iki kriter beraber kullanıldığında yüksek spesifisite gösterdi. Sonuç olarak, bu çalışmamızda EKG kriterleri ile akut inferior miyokard infarktüsünde infarkttan sorumlu arterin tahmin edilebileceğini gösterdik. İnfarktüsten sorumlu arterin erken ve doğru tanımlanabilmesi risk altındaki miyokard miktarını öngörebilmemize, klinik riski tahmin edebilmemize ve acil revaskülarizasyon için harekete geçmemize yardımcı olur.
FULL TEXT (PDF): 
PDF icon arastirmax-akut-inferior-miyokard-infarktusunde-sorumlu-arterin-ongorulmesinde-yeni-ekg-kriterleri.pdf
  • 1
17-20
  • Turkish

REFERENCES

References: 

1. Zimetbaum PJ, Krishnan S, Gold A, Carroza JP, Josepson
ME. Usefulness of ST segment elevation in lead III exceeding
that of lead II for identifying the location of the totally
occluded coronary artery in inferior wall myocardial
infarction. Am J Cardiol 1998; 8; 918-9.
2. Berger PB, Ryan TJ. Inferior myocardial infarction: High risk
subsets. Circulation 1990; 81: 401-11.
3. Herz I, Assali AR, Adler Y, Solodky A, Sclarovsky S. New
Electrocardiographic criteria for predicting either the right or
left circumflex artery as the culprit coronary artery in inferior
wall acute myocardial infarction. Am J Cardiol 1997; 80:
1343-5.
4. Judkins MP. Selective coronary arteriography: A percutaneous
transfemoral technique. Radiology 1967; 89: 815-24.
5. Sgarbossa EB, Wagner G: Electrocardiography. In E. Topol
(ed). Textbook of Cardiovascular Medicine. Philadelphia:
Lippincott-Raven; 1998; 1571-2.
6. Huey BL, Beller GA, Kaiser DL, Gibson RS. A
comprehensive analysis of myocardial infarction: comparison
with infarction due to right coronary artery and left anterior
descending artery occlusion. J Am Coll Cardiol 1998; 12:
1156-66.
7. Berry C, Zalewski A, Kovach R, Savage M, Goldberg S.
Surface electrocardiogram ischemia during coronary artery
occlusion. Am J Cardiol 1989; 63: 21-26.
8. Hiasa Y, Morimoto S, Wada T, Hamai K, Nakaya Y, Mori H.
Differentiation between left circumflex and right coronary
artery occlusions: Studies on ST segment deviation during
percutaneous transluminal coronary angioplasty. Clin Cardiol
1990; 13: 783-8. D. Çiçek, ark.
20
9. Shen WF, Tribouilloy C, Lesbre JP. Relationship between
electrocardiographic patterns and angiographic features in
isolated left circumflex coronary artery disease. Clin Cardiol
1991; 14: 720-4.
10. Andersen HR, Nielssen D, Falk E. Right ventricular
infarction: diagnostic value of ST elevation in lead 3
exceeding that of lead 2 during inferior / posterior infarction
and comparison with right-chest leads V3R to V7R. Am Heart
J 1989; 1117: 82-6.
11. Yokuşoğlu M, Kürşaklıoğlu H, Karaeren H, Erinç K, Amasyalı B, Demirtaş E. İnferior miyokard infarktüsünde yüzey
EKG’si ile suçlu arterin öngörülmesi MN Kardiyoloji 1999; 6:
4-7.
12. Birnbaum Y, Sclarovsky S, Mager A, Strasberg B, Redhavia
E. ST segment depression in aVL: a sensitive marker for acute
inferior myocardial infarction. Eur Heart J 1993; 14: 4-7.

Thank you for copying data from http://www.arastirmax.com