TY - JOUR
T1 - Relation of late potentials to ejection fraction and wall motion abnormalities in acute myocardial infarction
AU - Gomes, J. Anthony
AU - Horowitz, Steven F.
AU - Millner, Mark
AU - Machac, Josef
AU - Winters, Stephen L.
AU - Barreca, Phillip
N1 - Funding Information:
From the Clinical Electraphysiology and Electrocardiography Service and the Nuclear Cardiology Service, Division of Cardiology, Department of Medicine, Mount Sinai School of Mcdi-cinc of City University of New York and The Mount Sinai Medical Center, New York, New York. This work was supported in part by a grant from the Heart Research Foundation and a grant by Bernard and Josephine Chaus, New York, New York. Manuscript received October 23, 1986; revised manuscript received and accepted December 29, 1986. Address for reprints: 1. Anthony Games, MD, Electrophysiology and Electrocardiography Section, Mount Sinai Medical Center, 1 Gustave L. Levy Place, New York, New York 19929.
PY - 1987/5/1
Y1 - 1987/5/1
N2 - A prospective study was performed to determine the relation between quantitative signal-averaged parameters and ejection fraction (EF) and wall motion abnormalities determined by radionuclide ventriculography in patients with acute myocardial infarction (AMI). In 50 patients with AMI, signal-averaging of the surface QRS complex (200 beats; filter frequencies of 40 to 250 Hz and 80 to 250 Hz) was performed and radionuclide ventriculograms were recorded 8 ± 5 days after AMI. Twenty-five of these patients (50%) had anterior wall AMI, 20 (40%) had inferior wall AMI and 5 (10%) had non-Q-wave AMI. The duration of the low-amplitude signals of less than 40 μV, the signal-averaged QRS complex and the root-mean-square voltage of the terminal 40 ms were determined. In addition to EF determinations, wall motion abnormalities were assessed for the presence or absence of dyskinetic, akinetic and hypokinetic segments. A wall motion score was constructed by separating the left and right ventricles into 21 segments in the anterior, left anterior oblique and lateral views. On the basis of the presence or absence of late potentials, the patients were separated into 2 groups: group I comprised 15 patients (30%) with late potentials and group II 35 patients (70%) without late potentials. The low-amplitude signals (49 ± 12 vs 24 ± 8 ms) and the signal-averaged QRS complex (122 ± 20 vs 96 ± 15 ms) were significantly longer and the root-mean-square voltage (13.8 ± 4.9 vs 54.3 ± 27.4 μV) significantly lower in group I than in group II. However, EF (38 ± 14% vs 36 ± 12%), left and right ventricular wall motion abnormalities and left and right ventricular as well as combined wall motion scores were not significantly different between the groups. Thus, abnormal signal-averaged parameters are seen in 30% of patients with AMI and are independent of EF and wall motion abnormalities, and they may have independent prognostic value in patients who have had infarction.
AB - A prospective study was performed to determine the relation between quantitative signal-averaged parameters and ejection fraction (EF) and wall motion abnormalities determined by radionuclide ventriculography in patients with acute myocardial infarction (AMI). In 50 patients with AMI, signal-averaging of the surface QRS complex (200 beats; filter frequencies of 40 to 250 Hz and 80 to 250 Hz) was performed and radionuclide ventriculograms were recorded 8 ± 5 days after AMI. Twenty-five of these patients (50%) had anterior wall AMI, 20 (40%) had inferior wall AMI and 5 (10%) had non-Q-wave AMI. The duration of the low-amplitude signals of less than 40 μV, the signal-averaged QRS complex and the root-mean-square voltage of the terminal 40 ms were determined. In addition to EF determinations, wall motion abnormalities were assessed for the presence or absence of dyskinetic, akinetic and hypokinetic segments. A wall motion score was constructed by separating the left and right ventricles into 21 segments in the anterior, left anterior oblique and lateral views. On the basis of the presence or absence of late potentials, the patients were separated into 2 groups: group I comprised 15 patients (30%) with late potentials and group II 35 patients (70%) without late potentials. The low-amplitude signals (49 ± 12 vs 24 ± 8 ms) and the signal-averaged QRS complex (122 ± 20 vs 96 ± 15 ms) were significantly longer and the root-mean-square voltage (13.8 ± 4.9 vs 54.3 ± 27.4 μV) significantly lower in group I than in group II. However, EF (38 ± 14% vs 36 ± 12%), left and right ventricular wall motion abnormalities and left and right ventricular as well as combined wall motion scores were not significantly different between the groups. Thus, abnormal signal-averaged parameters are seen in 30% of patients with AMI and are independent of EF and wall motion abnormalities, and they may have independent prognostic value in patients who have had infarction.
UR - http://www.scopus.com/inward/record.url?scp=0023236692&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(87)90850-2
DO - 10.1016/0002-9149(87)90850-2
M3 - Article
C2 - 3578046
AN - SCOPUS:0023236692
SN - 0002-9149
VL - 59
SP - 1071
EP - 1074
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 12
ER -