PMID- 26966619
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160311
LR  - 20181113
IS  - 2146-3123 (Print)
IS  - 2146-3131 (Electronic)
IS  - 2146-3123 (Linking)
VI  - 33
IP  - 1
DP  - 2016 Jan
TI  - ST-Segment Elevation in the Right Precordial Leads in Patients with Acute 
      Anterior Myocardial Infarction.
PG  - 58-63
LID - 10.5152/balkanmedj.2015.15975 [doi]
AB  - BACKGROUND: Elevation of ST segment in leads V3R/ V4R, which is commonly 
      encountered in right ventricular myocardial infarction, may also occur in 
      patients with anterior ST elevation myocardial infarction (STEMI). However, the 
      clinical impact of this finding in the setting of anterior myocardial infarction 
      is not well understood. AIMS: We aimed to investigate the prognostic value of ST 
      segment elevation in leads V3R/V4R in patients with first acute anterior 
      myocardial infarction. STUDY DESIGN: Prospective cohort study. METHODS: Right 
      precordial leads V3R/V4R were recorded in 111 patients admitted with first time 
      anterior myocardial infarction. Patients were allocated into two groups based on 
      the presence or absence of ST elevation in leads V3R/V4R. Demographic, 
      biochemical and echocardiographic data, as well as the angiographic information, 
      were recorded. In-hospital and 3 month mortality, and major adverse cardiac 
      events (MACE), death, heart failure and ventricular dysrhythmia were also 
      compared. RESULTS: ST elevation in lead V3R or V4R was present in 72 out of 111 
      patients (64.9%). Involvement of the proximal part of the left anterior 
      descending (LAD) artery was not different in the two groups (44.4% of patients 
      with elevation vs. 53.8% of patients without elevation, p=0.22). Post-myocardial 
      infarction complications, mortality and major adverse cardiac events were similar 
      in the two groups. Left ventricular ejection fraction (LVEF) was significantly 
      lower in patients with ST elevation in V3R/V4R (35 %+/-8 vs. 38 %+/-8, p=0.02). 
      Twenty three out of 111 patients (20.7%) developed heart failure, which was 
      similar in the two groups [16 (22.2%) of patients with ST elevation vs. 7 (17.9%) 
      of patients without ST elevation, p=0.39]. CONCLUSION: Although ST elevation in 
      V3R/V4R can be present in patients with left anterior descending artery 
      occlusion, it does not seem to predict the prognosis. Lower left ventricular 
      ejection fraction in this group may play a role in the long-term prognosis; 
      however, this issue needs further investigation.
FAU - Pourafkari, Leili
AU  - Pourafkari L
AD  - Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular 
      Research Center, Tabriz, Iran.
FAU - Joudi, Saeid
AU  - Joudi S
AD  - Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular 
      Research Center, Tabriz, Iran.
FAU - Ghaffari, Samad
AU  - Ghaffari S
AD  - Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular 
      Research Center, Tabriz, Iran.
FAU - Tajlil, Arezou
AU  - Tajlil A
AD  - Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular 
      Research Center, Tabriz, Iran.
FAU - Kazemi, Babak
AU  - Kazemi B
AD  - Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular 
      Research Center, Tabriz, Iran.
FAU - Nader, Nader D
AU  - Nader ND
AD  - Department of Anesthesiology, University at Buffalo Jacobs School of Medicine and 
      Biomedical Sciences, New York, USA.
LA  - eng
PT  - Journal Article
DEP - 20160101
PL  - Turkey
TA  - Balkan Med J
JT  - Balkan medical journal
JID - 101571817
PMC - PMC4767311
OTO - NOTNLM
OT  - Acute anterior myocardial infarction
OT  - electrocardiograph
OT  - right ventricular dysfunction
EDAT- 2016/03/12 06:00
MHDA- 2016/03/12 06:01
PMCR- 2016/01/01
CRDT- 2016/03/12 06:00
PHST- 2014/11/27 00:00 [received]
PHST- 2015/06/15 00:00 [accepted]
PHST- 2016/03/12 06:00 [entrez]
PHST- 2016/03/12 06:00 [pubmed]
PHST- 2016/03/12 06:01 [medline]
PHST- 2016/01/01 00:00 [pmc-release]
AID - bmj-33-1-58 [pii]
AID - 10.5152/balkanmedj.2015.15975 [doi]
PST - ppublish
SO  - Balkan Med J. 2016 Jan;33(1):58-63. doi: 10.5152/balkanmedj.2015.15975. Epub 2016 
      Jan 1.