Journal of Electrocardiology
Volume 42, Issue 2 , Pages 112-117, March 2009

Determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction with ST-segment elevation

  • Munenori Kotoku, MD

      Affiliations

    • Internal Medicine 2, Oita University, Yufu, Japan
    • ,
  • Akira Tamura, MD

      Affiliations

    • Internal Medicine 2, Oita University, Yufu, Japan
    • Corresponding Author InformationCorresponding author. Internal Medicine 2, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu 879-5593, Japan. Tel.: +81 0 97 586 5804; fax: +81 0 97 549 4245.
    • ,
  • Yusei Abe, MD

      Affiliations

    • Division of Cardiovascular Medicine, Almeida Memorial Hospital, Oita, Japan
    • ,
  • Junichi Kadota, MD, PhD

      Affiliations

    • Internal Medicine 2, Oita University, Yufu, Japan

Received 24 July 2008 published online 08 December 2008.

Abstract 

Background

This study aimed to clarify the determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction (AAMI).

Methods

We analyzed ST-segment levels in all 12 leads on admission and emergency coronary angiographic findings in 261 patients with a first AAMI with ST-segment elevation. The length of the left anterior descending coronary artery (LAD) was classified as follows: short = not reaching the apex; medium = perfusing less than 25% of the inferior wall; long = perfusing 25% or more of the inferior wall.

Results

The ST-segment level in lead aVR correlated significantly with the ST-segment levels in leads I, II, III, aVF, V1, and V3-6, especially with those in leads II and V6 (r = −0.63, P < .001; r = −0.61, P < .001; respectively). Patients with a proximal LAD occlusion had a greater ST-segment level in lead aVR than those with a distal LAD occlusion (P < .001). Patients with a long LAD had a lower ST-segment level than those with a short or medium LAD (P < .05).

Conclusions

The ST-segment levels, especially in leads II and V6, the site of the LAD occlusion, and the length of the LAD affect the ST-segment level in lead aVR in ST-segment elevation AAMI.

Keywords: Electrocardiography, ST-segment, Lead aVR, Acute myocardial infarction

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PII: S0022-0736(08)00437-8

doi:10.1016/j.jelectrocard.2008.10.006

Journal of Electrocardiology
Volume 42, Issue 2 , Pages 112-117, March 2009

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