Abstract
Electrocardiographic and echocardiographic findings were compared in 44 patients with a first transmural infarction. Each patient was investigated on days 1, 2, 10, and 360. The electrocardiogram was classified according to QRS and ST segment changes. Local left ventricular function was determined from mean systolic wall velocity measurements by an M mode echocardiographic mapping technique in 10 of 16 segments suitable also for electrocardiographic evaluation. Mean systolic wall velocity was corrected for differences in anterior and inferior wall motion. Wall motion was normal in segments without QRS or ST changes throughout the study. All segments with QRS or ST changes showed significantly lower corrected systolic wall velocity values during the acute stage. Segments with ST depression, alone or in combination with a minor Q wave, had corrected mean systolic wall velocity values similar to those of normal segments after one year. Segments with major Q waves and all segments with ST elevation showed reduced corrected mean systolic wall velocity values throughout the study. Segments with ST elevation, irrespective of Q waves, showed the most severely reduced wall motion with significantly lower corrected mean values than segments with minor or major Q waves without ST elevation on days 10 and 360. Thus when electrocardiograms are used for defining local left ventricular function, consideration must be given to the phase of illness, QRS morphology, and presence of ST segment elevation.
Full text
PDF






Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Arkin B. M., Hueter D. C., Ryan T. J. Predictive value of electrocardiographic patterns in localizing left ventricular asynergy in coronary artery disease. Am Heart J. 1979 Apr;97(4):453–459. doi: 10.1016/0002-8703(79)90392-2. [DOI] [PubMed] [Google Scholar]
- Askenazi J., Maroko P. R., Lesch M., Braunwald E. Usefulness of ST segment elevations as predictors of electrocardiographic signs of necrosis in patients with acute myocardial infarction. Br Heart J. 1977 Jul;39(7):764–770. doi: 10.1136/hrt.39.7.764. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Awan N. A., Miller R. R., Vera Z., Janzen D. A., Amsterdam E. A., Mason D. T. Noninvasive assessment of cardiac function and ventricular dyssynergy by precordial Q wave mapping in anterior myocardial infarction. Circulation. 1977 Jun;55(6):833–838. doi: 10.1161/01.cir.55.6.833. [DOI] [PubMed] [Google Scholar]
- Bodenheimer M. M., Banka V. S., Helfant R. H. Q waves and ventricular asynergy: predictive value and hemodynamic significance of anatomic localization. Am J Cardiol. 1975 May;35(5):615–618. doi: 10.1016/0002-9149(75)90046-6. [DOI] [PubMed] [Google Scholar]
- COOK R. W., EDWARDS J. E., PRUITT R. D. Electrocardiographic changes in acute subendocardial infarction. I. Large subendocardial and large nontransmural infarcts. Circulation. 1958 Oct;18(4 Pt 1):603–612. doi: 10.1161/01.cir.18.4.603. [DOI] [PubMed] [Google Scholar]
- Cheng T. O. Incidence of ventricular aneurysm in coronary artery disease. An angiographic appraisal. Am J Med. 1971 Mar;50(3):340–355. doi: 10.1016/0002-9343(71)90223-3. [DOI] [PubMed] [Google Scholar]
- Gorlin R., Klein M. D., Sullivan J. M. Prospective correlative study of ventricular aneurysm. Mechanistic concept and clinical recognition. Am J Med. 1967 Apr;42(4):512–531. doi: 10.1016/0002-9343(67)90051-4. [DOI] [PubMed] [Google Scholar]
- Guyton R. A., McClenathan J. H., Newman G. E., Michaelis L. L. Significance of subendocardial S-T segment elevation caused by coronary stenosis in the dog. Epicardial S-T segment depression, local ischemia and subsequent necrosis. Am J Cardiol. 1977 Sep;40(3):373–380. doi: 10.1016/0002-9149(77)90159-x. [DOI] [PubMed] [Google Scholar]
- Hecht H. S., Taylor R., Wong M., Shah P. M. Comparative evaluation of segmental asynergy in remote myocardial infarction by radionuclide angiography, two-dimensional echocardiography, and contrast ventriculography. Am Heart J. 1981 Jun;101(6):740–749. doi: 10.1016/0002-8703(81)90609-8. [DOI] [PubMed] [Google Scholar]
- Heger J. J., Weyman A. E., Wann L. S., Dillon J. C., Feigenbaum H. Cross-sectional echocardiography in acute myocardial infarction: detection and localization of regional left ventricular asynergy. Circulation. 1979 Sep;60(3):531–538. doi: 10.1161/01.cir.60.3.531. [DOI] [PubMed] [Google Scholar]
- Heikkil J, Nieminen M. Echoventriculographic detection, localization, and quantification of left ventricular asynergy in acute myocardial infarction. A correlative echo- and electrocardiographic study. Br Heart J. 1975 Jan;37(1):46–59. doi: 10.1136/hrt.37.1.46. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Heikkilä J., Nieminen M. S. Rapid monitoring of regional myocardial ischaemia with echocardiography and ST segment shifts in man. Modification of "infarct size" and hemodynamics by dopamine and beta blockade. Acta Med Scand Suppl. 1978;623:71–95. doi: 10.1111/j.0954-6820.1979.tb00701.x. [DOI] [PubMed] [Google Scholar]
- Horan L. G., Flowers N. C., Johnson J. C. Significance of the diagnostic Q wave of myocardial infarction. Circulation. 1971 Mar;43(3):428–436. doi: 10.1161/01.cir.43.3.428. [DOI] [PubMed] [Google Scholar]
- Ideker R. E., Wagner G. S., Ruth W. K., Alonso D. R., Bishop S. P., Bloor C. M., Fallon J. T., Gottlieb G. J., Hackel D. B., Phillips H. R. Evaluation of a QRS scoring system for estimating myocardial infarct size. II. Correlation with quantitative anatomic findings for anterior infarcts. Am J Cardiol. 1982 May;49(7):1604–1614. doi: 10.1016/0002-9149(82)90235-1. [DOI] [PubMed] [Google Scholar]
- Ingels N. B., Jr, Daughters G. T., 2nd, Stinson E. B., Alderman E. L. Evaluation of methods for quantitating left ventricular segmental wall motion in man using myocardial markers as a standard. Circulation. 1980 May;61(5):966–972. doi: 10.1161/01.cir.61.5.966. [DOI] [PubMed] [Google Scholar]
- Jacobs J. J., Feigenbaum H., Corya B. C., Phillips J. F. Detection of left ventricular asynergy by echocardiography. Circulation. 1973 Aug;48(2):263–271. doi: 10.1161/01.cir.48.2.263. [DOI] [PubMed] [Google Scholar]
- Kerber R. E., Marcus M. L. Evaluation of regional myocardial function in ischemic heart disease by echocardiography. Prog Cardiovasc Dis. 1978 May-Jun;20(6):441–450. doi: 10.1016/0033-0620(78)90029-4. [DOI] [PubMed] [Google Scholar]
- Lindvall K., Erhardt L., Sjogren A. Echo- and electrocardiographic findings in relation to autopsy in myocardial infarction. Clin Cardiol. 1982 Jan;5(1):51–61. doi: 10.1002/clc.4960050106. [DOI] [PubMed] [Google Scholar]
- Lindvall K. M-mode echocardiographic mapping in differentiation of normal from dysfunctioning left ventricular myocardium. A study of patients with severe myocardial infarction and healthy controls. Acta Med Scand. 1981;209(3):149–160. doi: 10.1111/j.0954-6820.1981.tb11570.x. [DOI] [PubMed] [Google Scholar]
- Miller R. R., Amsterdam E. A., Bogren H. G., Massumi R. A., Zelis R., Mason D. T. Electrocardiographic and cineangiographic correlations in assessment of the location, nature and extent of abnormal left ventricular segmental contraction in coronary artery disease. Circulation. 1974 Mar;49(3):447–454. doi: 10.1161/01.cir.49.3.447. [DOI] [PubMed] [Google Scholar]
- Nieminen M. S. Normal left echoventriculography. Ann Clin Res. 1975 Feb;7(1):1–16. [PubMed] [Google Scholar]
- Nieminen M., Heikkilä J. Echoventriculography in acute myocardial infarction. III. Clinical correlations and implication of the noninfarcted myocardium. Am J Cardiol. 1976 Jul;38(1):1–8. doi: 10.1016/0002-9149(76)90054-0. [DOI] [PubMed] [Google Scholar]
- Nixon J. V., Brown C. N., Smitherman T. C. Identification of transient and persistent segmental wall motion abnormalities in patients with unstable angina by two-dimensional echocardiography. Circulation. 1982 Jun;65(7):1497–1503. doi: 10.1161/01.cir.65.7.1497. [DOI] [PubMed] [Google Scholar]
- Olsson G., Rehnqvist N., Lundman T., Melcher A. Metoprolol treatment after acute myocardial infarction. Effects on ventricular arrhythmias and exercise tests during 6 months. Acta Med Scand. 1981;210(1-2):59–65. [PubMed] [Google Scholar]
- Parisi A. F., Moynihan P. F., Folland E. D., Feldman C. L. Quantitative detection of regional left ventricular contraction abnormalities by two-dimensional echocardiography. II. Accuracy in coronary artery disease. Circulation. 1981 Apr;63(4):761–767. doi: 10.1161/01.cir.63.4.761. [DOI] [PubMed] [Google Scholar]
- Rose G. A., Blackburn H. Cardiovascular survey methods. Monogr Ser World Health Organ. 1968;56:1–188. [PubMed] [Google Scholar]
- Savage R. M., Wagner G. S., Ideker R. E., Podolsky S. A., Hackel D. B. Correlation of postmortem anatomic findings with electrocardiographic changes in patients with myocardial infarction: retrospective study of patients with typical anterior and posterior infarcts. Circulation. 1977 Feb;55(2):279–285. doi: 10.1161/01.cir.55.2.279. [DOI] [PubMed] [Google Scholar]
- Sniderman A. D., Marpole D., Fallen E. L. Regional contraction patterns in the normal and ischemic left ventricle in man. Am J Cardiol. 1973 Apr;31(4):484–489. doi: 10.1016/0002-9149(73)90299-3. [DOI] [PubMed] [Google Scholar]
- Wagner G. S., Freye C. J., Palmeri S. T., Roark S. F., Stack N. C., Ideker R. E., Harrell F. E., Jr, Selvester R. H. Evaluation of a QRS scoring system for estimating myocardial infarct size. I. Specificity and observer agreement. Circulation. 1982 Feb;65(2):342–347. doi: 10.1161/01.cir.65.2.342. [DOI] [PubMed] [Google Scholar]
- Williams R. A., Cohn P. F., Vokonas P. S., Young E., Herman M. V., Gorlin R. Electrocardiographic, arteriographic and ventriculographic correlations in transmural myocardial infarction. Am J Cardiol. 1973 May;31(5):595–599. doi: 10.1016/0002-9149(73)90328-7. [DOI] [PubMed] [Google Scholar]


