Japanese

Implications of anterior ST depression in acute inferior myocardial infarction Tomoya Onodera 1 , Masao Yasuno 1 , Reiji Kawata 1 , Yasuharu Ishida 1 , Hiroyuki Ohashi 1 , Yoshihiko Saito 1 , Hiraki Tanaka 1 1Division of Internal Medicine, Shizuoka Rosai Hospital pp.759-763
Published Date 1985/6/15
DOI https://doi.org/10.11477/mf.1404204688
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Implications of anterior ST depression in acute inferior myocardial infarction are controversial. We evaluated 37 patients with acute inferior infarction who admitted within 8 hours (mean 3.4 hours) after the onset of symptom. Thirty-five patients (94.6%) had ST depression greater than 0.1 mV in leads I, aVL or V1-6. The maximal ST elevation in II, III, aVF correlated well with the maximal ST depression in I, aVL (r=0.73) and did not correlate with the maximal ST depression in V1-4 (r=0.15). Patients with the maximal ST depression greater than 0.2 mV in V1-4 (ST↓(+) group, n= 27) had greater peak CPK and peak CPK-MB than those without such ST depression (ST↓(-) group, n=10) (CPK 1588±662 vs 838+388 IU)/l p<0.01, CPK-MB 407±203 vs 228+163 IU/l p<0.05). ST↓(+) group had larger technetium 99 m pyro-phosphate uptake than ST↓(-) group (1452±1450 vs 535±505 mm2 p<0.05). LV posterior wall uptake of technetium) 99m pyrophosphate was seen in 91.3% of ST↓(+) group and in 40% of ST↓(-) group (p<0.005). Stenosis of left anterior descending artery was seen in 55.6% of ST↓(+) group and in 70% of ST↓(-) group in coronary arteriography (NS). These data suggest that ST depression greater than 0.1 mV in leads I, aVL or V1-6 is commonly seen in acute phase of inferior myocardial infarction and ST depression in I, aVL is an electrically reciprocal phenomenon of ST elevation in II, III, aVF. But ST depression greater than 0.2 mV in V1-4 indicates a larger infarct size extended to LV posterior wall. These findings may detect high risk subset of patients in acute phase of inferior infarction and an aggressive therapy would be favorable to such patients.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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