PMID- 14516286
OWN - NLM
STAT- MEDLINE
DCOM- 20040227
LR  - 20200319
IS  - 1082-720X (Print)
IS  - 1542-474X (Electronic)
IS  - 1082-720X (Linking)
VI  - 8
IP  - 4
DP  - 2003 Oct
TI  - Are reciprocal changes a consequence of "ischemia at a distance" or merely a 
      benign electrical phenomenon? A pulsed-wave tissue Doppler echocardiographic 
      study.
PG  - 302-7
AB  - OBJECTIVES: The aim of the present study was to investigate whether ST segment 
      depression in precordial leads at the time of acute inferior myocardial 
      infarction represents a reciprocal change rather than concurrent anterior wall 
      ischemia on the surface electrocardiography. BACKGROUND: The mechanism of 
      reciprocal ST segment depression during acute myocardial infarction is 
      controversial. "Ischemia at a distance" or a benign electrical phenomenon has 
      been implicated in numerous reports. Pulsed-wave tissue Doppler (PWTD) 
      echocardiography can be used to examine the regional diastolic motion of the left 
      ventricular myocardial wall and may allow the detection of ischemic segments. 
      METHODS: We evaluated regional myocardial ischemia using PWTD echocardiography in 
      48 patients with a first inferior wall myocardial infarction. The left ventricle 
      was divided into 16 segments. PWTD echocardiographic velocities were obtained 
      from each left ventricular segments. RESULTS: Reciprocal ST segment depression 
      was present in 35 patients (Group 1) but not in the remaining 13 patients (Group 
      2). There were no significant differences between groups 1 and 2 with respect to 
      systolic (S) (7.4 +/- 1.1 vs 6.8 +/- 0.9 cm/s; P > 0.05), early (E) (10.5 +/- 2 
      vs 9.4 +/- 1.2 cm/s; P > 0.05), and late (A) (9.5 +/- 3.2 vs 8.5 +/- 2.3 cm/s; P 
      > 0.05) diastolic waves peak velocities, E/A ratio 1.1 +/- 0.2 vs 1.1 +/- 0.1; P 
      > 0.05), Ewave deceleration time (DT) (92 +/- 17 vs 101 +/- 16 ms; P > 0.05) and 
      regional relaxation time (RT) (82 +/- 19 vs 93 +/- 21 ms; P > 0.05) in anterior 
      wall (basal levels), which correspond to reciprocal ST segment depression on 
      electrocardiography. According to E/A ratio detected by PWTD echocardiography in 
      anterior wall and anterior septum, patients with reciprocal ST segment depression 
      were also divided into two groups: Group A, with E/A ratio > 1; Group B, with E/A 
      ratio < 1. Among the 35 patients with reciprocal ST segment depression, anterior 
      wall ischemia was present in 10 patients and absent in 25 patients, whereas 
      anterior septal ischemia was present 12 patients and absent in 23 patients. 
      CONCLUSIONS: Reciprocal ST segment depression during the early phases of inferior 
      infarction is an electrical reflection of primary ST segment elevation in the 
      area of infarction.
FAU - Celik, Sukru
AU  - Celik S
AD  - Department of Cardiology, KTU Faculty of Medicine, Trabzon, Turkey. 
      scelik@meds.ktu.edu.tr
FAU - Yilmaz, Remzi
AU  - Yilmaz R
FAU - Baykan, Merih
AU  - Baykan M
FAU - Orem, Cihan
AU  - Orem C
FAU - Erdol, Cevdet
AU  - Erdol C
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Ann Noninvasive Electrocardiol
JT  - Annals of noninvasive electrocardiology : the official journal of the 
      International Society for Holter and Noninvasive Electrocardiology, Inc
JID - 9607443
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Body Surface Potential Mapping
MH  - Cohort Studies
MH  - Echocardiography, Doppler/*methods
MH  - Female
MH  - Heart Function Tests
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnostic imaging/*pathology
MH  - Myocardial Ischemia/diagnostic imaging/pathology
MH  - Probability
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
PMC - PMC6932142
EDAT- 2003/10/01 05:00
MHDA- 2004/02/28 05:00
PMCR- 2003/09/30
CRDT- 2003/10/01 05:00
PHST- 2003/10/01 05:00 [pubmed]
PHST- 2004/02/28 05:00 [medline]
PHST- 2003/10/01 05:00 [entrez]
PHST- 2003/09/30 00:00 [pmc-release]
AID - 08407 [pii]
AID - ANEC08407 [pii]
AID - 10.1046/j.1542-474x.2003.08407.x [doi]
PST - ppublish
SO  - Ann Noninvasive Electrocardiol. 2003 Oct;8(4):302-7. doi: 
      10.1046/j.1542-474x.2003.08407.x.