PMID- 21511066
OWN - NLM
STAT- MEDLINE
DCOM- 20110922
LR  - 20161125
IS  - 1532-8430 (Electronic)
IS  - 0022-0736 (Linking)
VI  - 44
IP  - 3
DP  - 2011 May-Jun
TI  - Consideration of QRS complex in addition to ST-segment abnormalities in the 
      estimated "risk region" during acute anterior myocardial infarction.
PG  - 370-6
LID - 10.1016/j.jelectrocard.2011.01.004 [doi]
AB  - BACKGROUND: The myocardial area at risk (MaR) has been estimated in patients with 
      acute myocardial infarction (AMI) by using ST segment-based electrocardiographic 
      (ECG) methods. As the process from ischemia to infarction progresses, the 
      ST-segment deviation is typically replaced by QRS abnormalities causing a falsely 
      low estimated total MaR if determined by using ST segment-based methods. The 
      purpose of this study was to investigate if consideration of the abnormalities in 
      the QRS complex, in addition to those in the ST segment, provides a more accurate 
      estimated total MaR during anterior AMI than by considering the ST segment alone. 
      METHODS: Twenty-five patients with acute anterior ST elevation myocardial 
      infarction (STEMI) received technetium Tc 99m-sestamibi before percutaneous 
      coronary intervention. Single photon emission computed tomography (SPECT) was 
      performed within 2 hours after treatment and was used as a criterion standard for 
      the estimated total MaR. The ECG recorded at admission in the hospital was used 
      for the ECG estimated total MaR. This included an ST-segment estimated ischemic 
      component of the total MaR (Aldrich score) and an estimated infarcted component 
      of the total MaR in the acute phase of AMI by QRS abnormalities (Selvester 
      score). These scores were added for the combined ECG score. RESULTS: The ischemic 
      component of the total MaR estimated by the Aldrich score alone had no 
      statistically significant correlation with SPECT (r = 0.21, P = .32). The 
      infarcted component of the total MaR estimated by the Selvester score showed a 
      significant correlation with SPECT (r = 0.49, P = .01). Each score gave a 
      significant underestimated total MaR measured by SPECT (P < .01). When the 
      Aldrich and Selvester scores were combined, the correlation with SPECT was r = 
      0.47, P = .02. The combined score still underestimated the total MaR by SPECT (P 
      < .01), though the difference was smaller in comparison to either method alone (P 
      < .01). CONCLUSION: The ECG estimated total MaR was more accurate by taking both 
      ST deviation and QRS abnormalities into account than by using either method 
      alone. A new ECG method to determine the total MaR during acute coronary 
      occlusion should consider both its ischemic and infarcted components.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - van Hellemond, Irene E G
AU  - van Hellemond IE
AD  - Department of Cardiology, University Hospital Maastricht, Maastricht, The 
      Netherlands.
FAU - Bouwmeester, Sjoerd
AU  - Bouwmeester S
FAU - Olson, Charles W
AU  - Olson CW
FAU - Botker, Hans E
AU  - Botker HE
FAU - Kaltoft, Anne K
AU  - Kaltoft AK
FAU - Nielsen, Soren S
AU  - Nielsen SS
FAU - Terkelsen, Christian J
AU  - Terkelsen CJ
FAU - Maynard, Charles
AU  - Maynard C
FAU - Andersen, Mads P
AU  - Andersen MP
FAU - Gorgels, Anton P M
AU  - Gorgels AP
FAU - Wagner, Galen S
AU  - Wagner GS
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Electrocardiol
JT  - Journal of electrocardiology
JID - 0153605
RN  - 0 (Radiopharmaceuticals)
RN  - 971Z4W1S09 (Technetium Tc 99m Sestamibi)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Electrocardiography/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnostic imaging/*physiopathology
MH  - Radiopharmaceuticals
MH  - Reproducibility of Results
MH  - Risk Assessment
MH  - Signal Processing, Computer-Assisted
MH  - Technetium Tc 99m Sestamibi
MH  - *Tomography, Emission-Computed, Single-Photon
EDAT- 2011/04/23 06:00
MHDA- 2011/09/23 06:00
CRDT- 2011/04/23 06:00
PHST- 2010/08/11 00:00 [received]
PHST- 2011/04/23 06:00 [entrez]
PHST- 2011/04/23 06:00 [pubmed]
PHST- 2011/09/23 06:00 [medline]
AID - S0022-0736(11)00005-7 [pii]
AID - 10.1016/j.jelectrocard.2011.01.004 [doi]
PST - ppublish
SO  - J Electrocardiol. 2011 May-Jun;44(3):370-6. doi: 
      10.1016/j.jelectrocard.2011.01.004.