ST-segment deviation in lead aVR on admission is not associated with left ventricular function at predischarge in first anterior wall ST-segment elevation acute myocardial infarction.

Previous studies have shown that the analysis of ST-segment deviation in lead aVR on admission provides useful information on angiographic coronary anatomy and risk stratification in acute coronary syndromes. However, the association between ST-segment deviation in lead aVR on admission and left ventricular (LV) function has not been fully investigated in anterior wall acute ST-segment elevation myocardial infarction. In this study, 237 patients with first anterior wall acute ST-segment elevation myocardial infarction were examined. The patients were divided into the following 3 groups according to ST-segment deviation in lead aVR on admission: 85 with ST-segment elevation ≥0.5 mm (group A), 106 without ST-segment deviation (group B), and 46 with ST-segment depression ≥0.5 mm (group C). LV ejection fractions at predischarge were compared among the 3 groups. Among the 3 groups, there were significant differences in the prevalences of proximal left anterior descending coronary artery (LAD) occlusion (group A 75.3%, group B 56.6%, group C 45.7%, p = 0.002), long LAD (group A 27.1%, group B 31.1%, group C 56.5%, p = 0.002), and good collaterals to the LAD (group A 40.0%, group B 25.4%, group C 17.4%, p = 0.01). LV ejection fractions at predischarge did not differ among the 3 groups (group A 56.4 ± 12.5%, group B 56.9 ± 12.7%, group C 53.3 ± 12.2%, p = 0.26). On a multiple regression analysis, establishment of Thrombolysis In Myocardial Infarction grade 3 flow, proximal LAD occlusion, and long LAD were associated with the LV ejection fraction at predischarge. In conclusion, ST-segment deviation in lead aVR on admission is not associated with LV function at predischarge in first anterior wall acute ST-segment elevation myocardial infarction.

Goto Y ，Tamura A ，Kotoku M ，Kadota J ... -  《-》

ST-segment depression in lead aVR predicts predischarge left ventricular dysfunction in patients with reperfused anterior acute myocardial infarction with anterolateral ST-segment elevation.

Kosuge M ，Kimura K ，Ishikawa T ，Endo T ，Hongo Y ，Shigemasa T ，Iwasawa Y ，Tochikubo O ，Umemura S ... -  《AMERICAN HEART JOURNAL》

Clinical and angiographic characteristics of patients with combined anterior and inferior ST-segment elevation on the initial electrocardiogram during acute myocardial infarction.

Sadanandan S ，Hochman JS ，Kolodziej A ，Criger DA ，Ross A ，Selvester R ，Wagner GS ... -  《-》

Prognostic significance of ST segment changes in lead aVR in patients with acute inferior myocardial infarction with ST segment elevation.

Kukla P ，Bryniarski L ，Dudek D ，Królikowski T ，Kawecka Jaszcz K ... -  《-》

Acute anterior wall myocardial infarction entailing ST-segment elevation in lead V3R, V1 or aVR: electrocardiographic and angiographic correlations.

Zhong-qun Z ，Wei W ，Chong-quan W ，Shu-yi D ，Chao-rong H ，Jun-feng W ... -  《-》