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Titolo:
Exercise-induced negative U waves in precordial leads as a marker of viable myocardium in patients with recent anterior myocardial infarction
Autore:
Miwa, K; Igawa, A; Nakagawa, K; Hirai, T; Fujita, M; Inoue, H;
Indirizzi:
Toyama Med & Pharmaceut Univ, Dept Internal Med 2, Toyama 9300194, Japan Toyama Med & Pharmaceut Univ Toyama Japan 9300194 Toyama 9300194, Japan Kyoto Univ, Coll Med Technol, Kyoto 606, Japan Kyoto Univ Kyoto Japan 606 yoto Univ, Coll Med Technol, Kyoto 606, Japan
Titolo Testata:
INTERNATIONAL JOURNAL OF CARDIOLOGY
fascicolo: 2, volume: 73, anno: 2000,
pagine: 149 - 156
SICI:
0167-5273(20000428)73:2<149:ENUWIP>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
REDISTRIBUTION TL-201 TOMOGRAPHY; DESCENDING CORONARY-ARTERY; COLLATERAL CIRCULATION; DOBUTAMINE ECHOCARDIOGRAPHY; VENTRICULAR DYSFUNCTION; THALLIUM UPTAKE; INVERSION; VIABILITY; REINJECTION; PREDICTION;
Keywords:
exercise-induced negative U waves; anterior myocardial infarction; collateral circulation; viable myocardium;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Miwa, K Kansai Elect Power Hosp, Dept Internal Med 2, Fukushima Ku, 2-1-7 Fukushima, Osaka 5330003, Japan Kansai Elect Power Hosp 2-1-7 Fukushima Osaka Japan 5330003 Japan
Citazione:
K. Miwa et al., "Exercise-induced negative U waves in precordial leads as a marker of viable myocardium in patients with recent anterior myocardial infarction", INT J CARD, 73(2), 2000, pp. 149-156

Abstract

Patients with recent anterior myocardial infarction and a significant stenosis in the left anterior descending coronary artery were divided into two groups according to the presence (Group A, n=24) or absence (Group B, n=77)of negative U waves in the precordial leads during exercise stress test tocompare the coronary arteriographic findings. Both total occlusion of the left anterior descending coronary artery (79% vs. 31%, P<0.01)) and good (index=2,3) collateral circulation to the territory of this artery (92% vs. 36%, P<0.01) were observed more often in group A than in group B. In order to determine whether detection of exercise-induced negative U waves in precordial leads can predict the presence of viable myocardium, the 56 patients (20 of group A and 36 of group B) with total or subtotal occlusion of the left anterior descending coronary artery were studied further. The coronary arteriographic and exercise Tl-201 scintigraphic findings were compared between the groups. Good collateral circulation to the territory of this artery was observed significantly (P<0.05) more often in group A (100%) than in group B (61%). Patients with multivessel disease were significantly (P<0.05) more prevalent in group A (70%) than in group B (33%). The incidence of asignificant partial redistribution in the anteroseptal area in the Tl-201 images 4 h after exercise was significantly (P<0.01) higher in group A (85%) than in group B (39%). In 29 patients with anterior Q-wave myocardial infarction and exercise-induced ST elevation in precordial leads, a significant Tl-201 redistribution in the anteroseptal area was observed in 8 (80%) of10 patients of group A in contrast to only 4 (21%, P<0.05) of 19 in group B. In the diagnosis of the viability associated with Tl-201 redistribution in the anteroseptal area by the finding of exercise-induced negative U waves, the sensitivity was 67% and the specificity was 88% in these patients. We conclude that exercise-induced negative U waves in precordial leads are aconvenient and specific marker for the presence of viable myocardium in patients with recent anterior myocardial infarction. (C) 2000 Elsevier Science Ireland Ltd, All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 11:35:27