Why the study?
Does ST depression in lead aVR on 12-lead ECG accurately identify the left circumflex artery as the infarct-related artery in patients with acute inferior myocardial infarction?
Does ST depression in lead aVR on 12-lead ECG accurately identify the left circumflex artery as the infarct-related artery in patients with acute inferior myocardial infarction?
ST depression ≥ 0.1 mV in lead aVR on a standard 12-lead ECG is a highly specific marker for identifying the left circumflex artery as the infarct-related artery in acute inferior myocardial infarction.
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May aid LCX localization in inferior MI; hypothesis-generating and requires prospective validation before clinical adoption.
OBJECTIVES: To investigate whether the ST changes in the aVR lead on 12-lead ECG can be used to identify infarct-related artery (IRA) in patients with acute inferior myocardial infarction. METHODS: The ECG features were studied in 90 patients with acute inferior myocardial infarction where IRA was confirmed by coronary angiography. RESULTS: Right coronary artery (RCA) and the left circumflex coronary artery (LCX) were identified as IRA in 70 and 20 patients, respectively. ST depression in aVR > or = 0.1 mV was found in 14 (70%) patients who had LCX as the IRA, and in 4 (5.7%, p<0.001) patients with RCA as IRA. Using ST segment depression > or = 0.1 mV in aVR as a criterion, the sensitivity and specificity in differentiating LCX as IRA was 70.0% and 94.3%, respectively. CONCLUSIONS: ST depression in aVR is common in patients with LCX-related acute inferior myocardial infarction. The ST changes in this lead are associated with an excellent specificity and a good sensitivity in differentiating LCX from RCA as the IRA.
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Tongwen et al. (2007) studied this question.
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