Ischemic changes in lead aVR is associated with left ventricular thrombus or high-grade spontaneous echocontrast in patients with acute anterior myocardial infarction
Turk Kardiyoloji Dernegi Arsivi, cilt.47, sa.3, ss.168-176, 2018 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 47 Sayı: 3
- Basım Tarihi: 2018
- Doi Numarası: 10.5543/tkda.2018.57296
- Dergi Adı: Turk Kardiyoloji Dernegi Arsivi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.168-176
- Anahtar Kelimeler: Lead aVR, left ventricular thrombus, myocardial infarction
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: The aim of this study was to investigate the relationship between ischemic changes in the lead aVR and left ventricular thrombus (LVT) or high-grade spontaneous echo contrast (SEC) in patients with acute anterior myocardial infarction (MI). Methods: Quantitative T wave polarity in lead aVR (TPaVR) and ST segment deviation in the lead aVR (STaVR) measured from a surface electrocardiogram (ECG), as well as the absolute numerical values, were recorded. The ST/TPaVR ratio was obtained by dividing the larger absolute value by the smaller. The presence of LVT or high-grade SEC was recorded using echocardiograpy. The SYNTAX score (SS), clinical SS (cSS), and residual SS (rSS) were calculated from angiography results. Results: A total of 34 patients with LVT or high-grade SEC were included in Group 1. Group 2 comprised 170 patients who did not have any LVT or high-grade SEC. The P wave duration, V2 ST-segment elevation, TPaVR, cSS, and ST/TPaVR ratio were significantly higher in Group 1. The ejection fraction (EF) and STaVR were significantly higher in Group 2. The EF (Odds ratio [OR]: 0.9, 95% confidence interval [CI]: 0.833-0.973; p=0.008), TPaVR (OR: 1.454, 95% CI: 1.074-1.967; p=0.015), and ST/TPaVR ratio (OR: 1.6, 95% CI: 1.307-1.959; p<0.001) were determined to be independent predictors for Group 1. Conclusion: Ischemic changes in the lead aVR are closely associated with LVT or high-grade SEC in anterior MI patients.