Journal of Electrocardiology
Volume 41, Issue 4 , Pages 335-341, July 2008

Value of lead aVR in predicting acute occlusion of proximal left anterior descending coronary artery and in-hospital outcome in ST-elevation myocardial infarction: an electrocardiographic predictor of poor prognosis

  • Nazif Aygul, MD

      Affiliations

    • Meram Faculty of Medicine, Cardiology Department, Selcuk University, Konya, Turkey
    • Corresponding Author InformationCorresponding author. Selcuk Universitesi, Meram Tip Fakultesi, Kardiyoloji AD, 42080 Meram, Konya, Turkey. Tel.: +90 533 653 1042; fax: +90 332 237 3721.
    • ,
  • Kurtulus Ozdemir, MD

      Affiliations

    • Meram Faculty of Medicine, Cardiology Department, Selcuk University, Konya, Turkey
    • ,
  • Mehmet Tokac, MD

      Affiliations

    • Meram Faculty of Medicine, Cardiology Department, Selcuk University, Konya, Turkey
    • ,
  • Meryem Ulku Aygul, MD

      Affiliations

    • Meram Faculty of Medicine, Cardiology Department, Selcuk University, Konya, Turkey
    • ,
  • Mehmet Akif Duzenli, MD

      Affiliations

    • Meram Faculty of Medicine, Cardiology Department, Selcuk University, Konya, Turkey
    • ,
  • Adnan Abaci, MD

      Affiliations

    • Faculty of Medicine, Cardiology Department, Gazi University, Ankara, Turkey
    • ,
  • Ahmet Bacaksiz, MD

      Affiliations

    • Meram Faculty of Medicine, Cardiology Department, Selcuk University, Konya, Turkey
    • ,
  • Hüseyin Yazici, MD

      Affiliations

    • Faculty of Medicine, Cardiology Department, Gazi University, Ankara, Turkey
    • ,
  • Sait Bodur, MD

      Affiliations

    • Meram Faculty of Medicine, Public Health Department, Selcuk University, Konya, Turkey

Received 9 December 2007 published online 02 May 2008.

Abstract 

Background

We aimed to investigate the value of ST elevation in lead aVR (ST↑aVR) in predicting the left anterior descending coronary artery (LAD) occlusion site proximal to first septal perforator (S1) and its effect on in-hospital outcome in ST-elevation myocardial infarction (STEMI).

Methods

The study included 950 patients with STEMI. Patients were divided into 2 groups as aVR(+) and aVR(−) according to the presence of an ST↑aVR of 0.5 mm or greater.

Results

ST elevation in lead aVR was seen in 155 (16%) patients, and LAD occlusion proximal to S1 was detected in 52% of patients in the aVR(+) group and in 9% of patients in the aVR(−) group. aVR positivity was associated with higher heart rate, lower systolic blood pressure and ejection fraction, and worse Killip class at the hospital admission. In-hospital mortality was 19% in the aVR(+) group and 5% in the aVR(−) group. aVR positivity was an independent predictor of in-hospital death.

Conclusion

This study revealed that ST↑aVR was not only a good indicator of LAD occlusion proximal to S1 but also a source of valuable information about in-hospital outcome in patients with STEMI.

Keywords: Electrocardiography, In-hospital mortality, Lead aVR, Left anterior descending coronary artery, ST elevation myocardial infarction

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0022-0736(08)00083-6

doi:10.1016/j.jelectrocard.2008.02.025

Journal of Electrocardiology
Volume 41, Issue 4 , Pages 335-341, July 2008

Article Tools

* Image Usage & Resolution