Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging

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Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging. / Allencherril, Joseph; Fakhri, Yama; Engblom, Henrik; Heiberg, Einar; Carlsson, Marcus; Dubois-Rande, Jean Luc; Halvorsen, Sigrun; Hall, Trygve S.; Larsen, Alf Inge; Jensen, Svend Eggert; Arheden, Hakan; Atar, Dan; Clemmensen, Peter; Ripa, Maria Sejersten; Birnbaum, Yochai.

I: Journal of Electrocardiology, Vol. 51, Nr. 4, 01.07.2018, s. 563-568.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

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Allencherril, J, Fakhri, Y, Engblom, H, Heiberg, E, Carlsson, M, Dubois-Rande, JL, Halvorsen, S, Hall, TS, Larsen, AI, Jensen, SE, Arheden, H, Atar, D, Clemmensen, P, Ripa, MS & Birnbaum, Y 2018, 'Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging', Journal of Electrocardiology, vol. 51, nr. 4, s. 563-568. https://doi.org/10.1016/j.jelectrocard.2018.03.016

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Allencherril, Joseph ; Fakhri, Yama ; Engblom, Henrik ; Heiberg, Einar ; Carlsson, Marcus ; Dubois-Rande, Jean Luc ; Halvorsen, Sigrun ; Hall, Trygve S. ; Larsen, Alf Inge ; Jensen, Svend Eggert ; Arheden, Hakan ; Atar, Dan ; Clemmensen, Peter ; Ripa, Maria Sejersten ; Birnbaum, Yochai. / Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging. I: Journal of Electrocardiology. 2018 ; Vol. 51, Nr. 4. s. 563-568.

RIS

TY - JOUR

T1 - Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging

AU - Allencherril, Joseph

AU - Fakhri, Yama

AU - Engblom, Henrik

AU - Heiberg, Einar

AU - Carlsson, Marcus

AU - Dubois-Rande, Jean Luc

AU - Halvorsen, Sigrun

AU - Hall, Trygve S.

AU - Larsen, Alf Inge

AU - Jensen, Svend Eggert

AU - Arheden, Hakan

AU - Atar, Dan

AU - Clemmensen, Peter

AU - Ripa, Maria Sejersten

AU - Birnbaum, Yochai

PY - 2018/7/1

Y1 - 2018/7/1

N2 - 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.

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.

KW - Cardiology

KW - Electrocardiography

KW - Magnetic resonance imaging

KW - Myocardial infarction

KW - ST elevations

UR - http://www.scopus.com/inward/record.url?scp=85046749862&partnerID=8YFLogxK

U2 - 10.1016/j.jelectrocard.2018.03.016

DO - 10.1016/j.jelectrocard.2018.03.016

M3 - Article

VL - 51

SP - 563

EP - 568

JO - Journal of Electrocardiology

T2 - Journal of Electrocardiology

JF - Journal of Electrocardiology

SN - 1532-8430

IS - 4

ER -