Key result
The sum of R wave and QRS score on 12-lead ECG before discharge significantly correlated with the opacification index (r=0.59 and r=0.33, p<0.05), suggesting they are useful markers of myocardial perfusion in acute myocardial infarction.
Why the study?
Do serial ECG changes (R wave and QRS score) correlate with myocardial perfusion status in patients with first anterior wall acute myocardial infarction?
Observational (n=41)
No
Do serial ECG changes (R wave and QRS score) correlate with myocardial perfusion status in patients with first anterior wall acute myocardial infarction?
Effect estimate: r=0.59
p-value: p=<0.05
ECG changes in R wave and QRS scores are useful markers of myocardial perfusion state in patients with acute myocardial infarction undergoing thrombolytic therapy.
ECG R-wave and QRS scores may indicate perfusion status in anterior AMI; leaves open prospective validation before clinical adoption.
Background and Objectives:The restoration of infarct-related coronary artery (IRA patency in acute myocar- dial infarction (AMI linked to a significant improvement in survival. Because of microvascular and cellular injury, patent IRA does not always represent successful reperfusion. With progress of myocardial ischemia, standard 12 lead ECG shows evolutional changes of ST-segment, R wave and Q wave. But their relations to my- ocardial perfusion were uncertain. Methods:Total 41 patients of the first anterior wall AMI were enrolled and serial ECGs were taken to measure sum of ST-segment elevation (∑ST, sum of Q wave (∑Q, sum of R wave (∑R, and QRS score (QRSs proposed by Selvester in each patients before thrombolytic therapy (i, after co- ronary angiography at 90 minutes of thrombolytic therapy (a, and before discharge (d. Myocardial contrast echocardiography was performed within 10 days of AMI to estimate opacification score (OS and opacification index (OI in segments of LAD territory. We investigate the relation between evolution of ECG changes and perfusion status of infarcted myocardium. Results:1 There was no relation between OI and ∑ST, but ∑R and QRSs showed significant relation with OI before discharge (r=0.59, -0.33, p<0.05, respectively, post throm- bolytic therapy (r=0.51, -0.61, p<0.05, and baseline ECG (r=0.53, -0.51, p<0.05. 2 The number of segments with OS (0.5 showed no singificant relation to the degree of ∑ST and ∑Q, but number of segments with OS (0 showed singinficant relation to that of ∑R and QRSs (r of ∑Ri, ∑Ra, ∑Rd vs number of segments with OS (0=-0.59, -0.66, -0.43, p<0.05, QRSi, QRSa, QRSd vs number of segments with OS (0=0.58, 0.58, 0.57, p<0.05. Conclusion:These findings suggest that the ECG changes of R wave and QRS scores could be useful markers of perfusion state in thrombolytic era. (Korean Circulation J 1998;28(10 :1707-1716
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Ahn et al. (1998) conducted an observational in Acute myocardial infarction (n=41). 12-lead ECG (R wave and QRS score) was evaluated on Correlation between Opacification Index (OI) and sum of R wave (ÔR) before discharge (r=0.59, p=<0.05). The sum of R wave and QRS score on 12-lead ECG before discharge significantly correlated with the opacification index (r=0.59 and r=0.33, p<0.05), suggesting they are useful markers of myocardial perfusion in acute myocardial infarction.
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