PMID- 29996989
OWN - NLM
STAT- MEDLINE
DCOM- 20190528
LR  - 20190528
IS  - 1532-8430 (Electronic)
IS  - 0022-0736 (Linking)
VI  - 51
IP  - 4
DP  - 2018 Jul-Aug
TI  - Correlation of anteroseptal ST elevation with myocardial infarction territories 
      through cardiovascular magnetic resonance imaging.
PG  - 563-568
LID - S0022-0736(18)30126-2 [pii]
LID - 10.1016/j.jelectrocard.2018.03.016 [doi]
AB  - BACKGROUND: Anteroseptal ST elevation myocardial infarction (STEMI) is 
      traditionally defined on the electrocardiogram (ECG) by ST elevation (STE) in 
      leads V1-V3, with or without involvement of lead V4. It is commonly taught that 
      such infarcts affect the basal anteroseptal myocardial segment. While there are 
      suggestions in the literature that Q waves limited to V1-V4 represent 
      predominantly apical infarction, none have evaluated anteroseptal ST elevation 
      territories. We compared the distribution of the myocardium at risk (MaR) in 
      STEMI patients presenting with STE limited to V1-V4 and those with more extensive 
      STE (V1-V6). METHODS: We identified patients in the MITOCARE study presenting 
      with a first acute STEMI and new STE in at least two contiguous anterior leads 
      from V1 to V6. Patients underwent cardiac magnetic resonance (CMR) imaging three 
      to five days after acute infarction. RESULTS: Thirty-two patients met inclusion 
      criteria. In patients with STE in V1-V4 (n = 20), myocardium at risk (MaR) > 50% 
      was seen in 0%, 85%, 75%, 100%, and 90% in the basal anteroseptal, mid 
      anteroseptal, apical anterior, apical septal segments, and apex, respectively. 
      The group with STE in V1-V6 (n = 12), MaR > 50% was seen in 8%, 83%, 83%, 92%, 
      and 83% of the same segments. CONCLUSIONS: Patients with acute STEMI and STE in 
      leads V1-V4, exhibit MaR in predominantly apical territories and rarely in the 
      basal anteroseptum. We found no evidence to support existence of isolated basal 
      anteroseptal or septal STEMI. "Anteroapical" infarction is a more precise 
      description than "anteroseptal" infarction for acute STEMI patients exhibiting 
      STE in V1-V4.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Allencherril, Joseph
AU  - Allencherril J
AD  - Section of Cardiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 
      USA. Electronic address: allenche@bcm.edu.
FAU - Fakhri, Yama
AU  - Fakhri Y
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, University of 
      Copenhagen, Copenhagen, Denmark; Department of Medicine, Nykobing F Hospital, 
      Nykobing F, Denmark.
FAU - Engblom, Henrik
AU  - Engblom H
AD  - Department of Clinical Physiology, Lund University, Skane University Hospital, 
      Lund, Sweden.
FAU - Heiberg, Einar
AU  - Heiberg E
AD  - Department of Clinical Physiology, Lund University, Skane University Hospital, 
      Lund, Sweden.
FAU - Carlsson, Marcus
AU  - Carlsson M
AD  - Department of Clinical Physiology, Lund University, Skane University Hospital, 
      Lund, Sweden.
FAU - Dubois-Rande, Jean-Luc
AU  - Dubois-Rande JL
AD  - Assistance Publique Hopitaux de Paris, Hopital Henri Mondor, Creteil, France.
FAU - Halvorsen, Sigrun
AU  - Halvorsen S
AD  - Department of Cardiology B, Oslo University Hospital Ulleval, and Faculty of 
      Medicine, Al, Oslo, Norway.
FAU - Hall, Trygve S
AU  - Hall TS
AD  - Department of Cardiology B, Oslo University Hospital Ulleval, and Faculty of 
      Medicine, Al, Oslo, Norway.
FAU - Larsen, Alf-Inge
AU  - Larsen AI
AD  - Department of Cardiology, Stavanger University Hospital, Stavanger, Norway; 
      Department of Clinical Science, University of Bergen, Bergen, Norway.
FAU - Jensen, Svend Eggert
AU  - Jensen SE
AD  - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; 
      Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
FAU - Arheden, Hakan
AU  - Arheden H
AD  - Department of Clinical Physiology, Lund University, Skane University Hospital, 
      Lund, Sweden.
FAU - Atar, Dan
AU  - Atar D
AD  - Department of Cardiology B, Oslo University Hospital Ulleval, and Faculty of 
      Medicine, Al, Oslo, Norway.
FAU - Clemmensen, Peter
AU  - Clemmensen P
AD  - Department of Medicine, Nykobing F Hospital, Nykobing F, Denmark; Institute of 
      Regional Health Research, University of Southern Denmark, Odense, Denmark; 
      Department of General and Interventional Cardiology, University Heart Center 
      Hamburg-Eppendorf, Hamburg, Germany.
FAU - Ripa, Maria Sejersten
AU  - Ripa MS
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, University of 
      Copenhagen, Copenhagen, Denmark.
FAU - Birnbaum, Yochai
AU  - Birnbaum Y
AD  - Section of Cardiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 
      USA.
LA  - eng
PT  - Clinical Trial, Phase II
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20180404
PL  - United States
TA  - J Electrocardiol
JT  - Journal of electrocardiology
JID - 0153605
SB  - IM
MH  - Aged
MH  - Double-Blind Method
MH  - *Electrocardiography
MH  - Female
MH  - Heart/diagnostic imaging
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - ST Elevation Myocardial Infarction/diagnosis/*diagnostic imaging/physiopathology
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Cardiology
OT  - Electrocardiography
OT  - Magnetic resonance imaging
OT  - Myocardial infarction
OT  - ST elevations
EDAT- 2018/07/13 06:00
MHDA- 2019/05/29 06:00
CRDT- 2018/07/13 06:00
PHST- 2018/02/20 00:00 [received]
PHST- 2018/03/23 00:00 [revised]
PHST- 2018/03/30 00:00 [accepted]
PHST- 2018/07/13 06:00 [entrez]
PHST- 2018/07/13 06:00 [pubmed]
PHST- 2019/05/29 06:00 [medline]
AID - S0022-0736(18)30126-2 [pii]
AID - 10.1016/j.jelectrocard.2018.03.016 [doi]
PST - ppublish
SO  - J Electrocardiol. 2018 Jul-Aug;51(4):563-568. doi: 
      10.1016/j.jelectrocard.2018.03.016. Epub 2018 Apr 4.