ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2020
Diagnostic flowchart to estimate the morphology of left descending artery lesions by initial electrocardiogram in ST-elevation myocardial infarction.
Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 6 citations in OpenAlex.
- Abnormal Electrocardiogram in a Man Presenting With Dyspnea and Chest Pain.Texas Heart Institute journal · 2022Article
- Diagnostic flowchart to estimate the morphology of left descending artery lesions by initial electrocardiogram in ST-elevation myocardial infarction.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2020Article
- Open Access for the Annals of Noninvasive Electrocardiology.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2020Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundST-segment deviations in an initial 12-lead electrocardiogram provide anatomical information in ST-elevation myocardial infarction (STEMI). A diagnostic flowchart was formulated to estimate the anatomical characteristics of a culprit left anterior descending artery (LAD).
methodsThe present study analyzed 252 STEMI patients whose culprit lesions were confirmed to be LAD as an observational study. LAD morphology, wrapped (n = 26) or not (n = 226), and the positional relationship to first diagonal branch (n = 162 in proximal, n = 90 in distal lesions) were assessed. Their ST-segment deviations and such anatomical characteristics were examined.
resultsReciprocal ST depression in nonwrapped LAD was frequent in patients without diagonal branch flow (49.3%-18.8% in II, p < .01; 66.4%-36.3% in III, p < .01; 63.7%-30.0% in aVF, p < .01). ST elevation in inferior leads was the characteristics of wrapped LAD but was not the case in patients without diagonal flow (50%-0% in II, 60%-0% in III, and 60%-0% in aVF). ST elevation in lateral leads to the diagonal branch in nonwrapped LAD is more frequent for proximal than distal lesions (36.3% vs. 15.0% in I, p < .01; 50.7% vs. 16.3% in aVL, p < .01), but this was not observed for wrapped LAD (18.8% vs. 20.0% in I, p = .72; 31.3% vs. 10.0% in aVL, p = .21). Positive and negative predictive values for the diagnostic accuracy of suggested diagnostic flow based on the above results were 0.794 and 0.478, respectively.
conclusionsOur suggested diagnostic flowchart provides enough diagnostic accuracy to estimate culprit morphology.
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