Advance Search

The Effect of Precordial ST-Segment Depression in Inferior ST-Segment Elevation Myocardial Infarction on Left Ventricular Systolic Function :Two-Dimensional Echocardiographic Study

Abdulkareem A. AL-Othman
Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
Keywords:
Copyright and Licensing:
Copyright Notice
Share:
  • Articles
  • Submited: October 25, 2018
  • Published: October 25, 2018

Abstract

Background and Objectives: The importance of precordial ST-segment depression in patients with early inferior ST-segment elevation myocardial infarction remain unclear. Many studies have reported that patients with precordial ST-segment depression appear to have large infarctions.

The objectives of this study was to evaluate the effect of precordial ST-segment depression in patients with early inferior ST-segment elevation myocardial infarction on the left ventricular systolic function and left ventricular regional wall abnormalities.

Patients & Methods: Fifty eight patients with first inferior ST-segments elevation myocardial infarction (37 male, 21 female), their ages ranged from 30-91year,mean age 60.59±11.21 who underwent thrombolysis in the Coronary Care Unit of Erbil Teaching Hospital for the period from August 2008 to August 2009 were included in this study. Two-dimensional echocardiography was performed in the first week of acute inferior myocardial infarction. Patients were classified according to the absence (group I, 30 ,51.72%) or presence (group II ,28 , 48.28%) of precordial ST- segment depression .

Results: Group-II patients had a higher significant incidence of left ventricular systolic dysfunction (8,28.57%) than group I (2,6.67%),P=0.027 ,despite thrombolytic therapy (alteplase). Group-II patients had higher significant incidence of left ventricular regional wall abnormalities ( 12,42.9%) than group-I (3,10%),P 0.00 ,despite thrombolytic therapy (alteplase).

Conclusions: Early two-dimensional echocardiography is recommended for patients with inferior ST-segment elevation myocardial infarction associated with precordial ST-segment depression for the earliest detection of regional wall abnormalities and left ventricular systolic dysfunction.

PDF
PDF

Metrics

Metrics Loading ...

References

  1. Croft CH,Woodward, Nicod P,et al.clinical implications of anterior ST segment depression in patients with acute inferior myocardial infarction.AM J Cardiol 1982;50:428-336.
  2. Shah PK, Pichler M,Berman DS,et al .Noninvasive identification of a high risk subset of patients with acute inferior myocardial infarction.Am J Cardiol 1980;46:915-21
  3. Harvey Feigenbaum,William F,Armstrong ,Thomas Ayan .Coronary Artery Disease. In Feigenbaums´s Echocardiography,Edited by Harvey Feigenbaum,William F,Armstrong ,Thomas Ayan.6th edition.Lippincott Williams & Wilkins,A wolker kluner Company,2005,pp138-469.
  4. Davies MK, Hobbs FDR, Davis RC et al. Prevalence of left-ventricular systolic dysfunction and heart failure in the Echocardiographic Heart of England Screening study: a population based study. Lancet 2001;358: 439-44.
  5. Cowie MR, Wood DA, Coats AJ et al. Survival of patients with a new diagnosis of heart failure: a population based study. Heart 2000;83:505-10.
  6. Cleland JG,Swedberg K,Folath F, The Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of cardiology. The EuroHeart Failure survey programme , a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis.Eur Heart J 2003;24:442-63
  7. Peterson ED,Hathaway WR,Zabel M,Pieper KS,Grancer CB,Wagner GS,Bates ER,Silmons ML,Califf RM,Prognostic significance of precordial ST Deptression during inferior myocardial infarction in the thrombolytic era:results in 16521 patients.JACC,Vol.28,No2 August 1996:305-12.
  8. Elliot M.Antman,Eugen Braunwald ,ST-elevation myocardial infarction: pathology, pathophysiology,and clinical features, In Braunwald s Heart Disease,a Textbook of Cardiovascular Medicine,Edited by:Douglas P.Zipes,Peter libby,Robert O.Bonow,Eugene Braunwald.7th Edition.Elsevier Sauders Company,2005,pp1141-1165.
  9. Bloomfield P,Bradbury A,Grubb NR.Obesity,presenting problems of altered energy balane,Enviromental and nutritional factors in disease. In Davidson's Principles and Practice of Medicine.Edited by Bloomfield P,Bradbury A,Grubb N.20th Edition,London,Churchill livingstone,2006,pp111-112.
  10. Jeffrey L.Anderson ,Fibrinolytic therapy of ST elevation myocardial infarction, In Cecil Text Book of Medicine,Edited by Lee Goldman,Dennis Ausiello,23rd edition.Saunders Elsevier,2007,PP 508.
  11. Ramdas G,Pai and Pravin M.Shah, Assessment of left ventricular function . in Imaging in Cardiovascular Disease, Edited by Gerald M. pohost,Robert A.O,Daniel S, Berman,Pravin m,Lippincott Williams & Wilkins.2000,pp23-41.
  12. Schiller N, Shah PM,Crawford M.Recommendation for quantitation of the left ventricle by two-dimensional echocardiography.J Am Soc Echocardiography 1989;2:358-68.
  13. Salcedo JR, Baird MG, Chambers RJ, Beanlands DS. Significance of reciprocal S-T segment depression in anterior precordial leads in acute inferior myocardial infarction: concomitant left anterior descending coronary artery disease? Am J Cardiol 1981;48:1003–8
  14. Haraphongse M, Jugdutt BI, Rossall RE. Significance of precordial ST segment depression in acute transmural inferior infarction: coronary angiographic findings. Cathet Cardiovasc Diagn 1983;9:143–51
  15. Roubin GS, Shen WF, Nicholson M, Dunn RF, Kelly DT, Harris PJ. Anterolateral ST segment depression in acute inferior myocardial infarction: angiographic and clinical implications. Am Heart J 1984;107:1177–82.
  16. Tendera M, Campbell B. Significance of early and late anterior precordial ST-segment depression in inferior myocardial infarction. Am J Cardiol 1984;54:994–6.
  17. Pierard LA,Sprynger M,Gilis F,Carlier J.significance of precordial ST segment depression in inferior acute inferior myocardial infarction as determined by echocardiography.Am J Cardiol 1986;57:82-5.
How to Cite
AL-Othman, A. A. (2018). The Effect of Precordial ST-Segment Depression in Inferior ST-Segment Elevation Myocardial Infarction on Left Ventricular Systolic Function :Two-Dimensional Echocardiographic Study. Zanco Journal of Medical Sciences (Zanco J Med Sci), 14(1 Special), 8–13. Retrieved from https://zjms.hmu.edu.krd/index.php/zjms/article/view/471

Send mail to Author

Send Cancel