Archives of the Turkish Society of Cardiology
Ischemic changes in lead aVR is associated with left ventricular thrombus or high-grade spontaneous echocontrast in patients with acute anterior myocardial infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-57296 | DOI: 10.5543/tkda.2018.57296

Ischemic changes in lead aVR is associated with left ventricular thrombus or high-grade spontaneous echocontrast in patients with acute anterior myocardial infarction

Yahya Kemal Içen1, Yurdaer Dönmez1, Abdullah Orhan Demirtaş1, Hasan Koca1, Mustafa Lutfullah Ardıç1, Ayse Selcan Koc2, Fadime Karataş1, Mevlut Koc1
1Health Sciences University Adana Health Practices and Research Center Cardiology Department
2Health Sciences University Adana Health Practices and Research Center Radiology Department


OBJECTIVE
The aim of this study was to investigate the relationship between ischemic changes in the lead aVR and left ventricular thrombus (LVT) or high-grade spontaneous echo contrast (SEC) in patients with acute anterior myocardial infarction (MI).

METHODS
Quantitative T wave polarity in lead aVR (TPaVR) and ST segment deviation in the lead aVR (STaVR) measured from a surface electrocardiogram (ECG), as well as the absolute numerical values, were recorded. The ST/TPaVR ratio was obtained by dividing the larger absolute value by the smaller. The presence of LVT or high-grade SEC was recorded using echocardiograpy. The SYNTAX score (SS), clinical SS (cSS), and residual SS (rSS) were calculated from angiography results.

RESULTS
A total of 34 patients with LVT or high-grade SEC were included in Group 1. Group 2 comprised 170 patients who did not have any LVT or high-grade SEC. The P wave duration, V2 ST-segment elevation, TPaVR, cSS, and ST/TPaVR ratio were significantly higher in Group 1. The ejection fraction (EF) and STaVR were significantly higher in Group 2. The EF (Odds ratio [OR]: 0.9, 95% confidence interval [CI]: 0.833–0.973; p=0.008), TPaVR (OR: 1.454, 95% CI: 1.074–1.967; p=0.015), and ST/TPaVR ratio (OR: 1.6, 95% CI: 1.307–1.959; p<0.001) were determined to be independent predictors for Group 1.

CONCLUSION
Ischemic changes in the lead aVR are closely associated with LVT or high-grade SEC in anterior MI patients.

Keywords: Myocardial infarction, left ventricular thrombus, lead aVR.

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Corresponding Author: Yahya Kemal Içen, Türkiye
© Copyright 2018 Archives of the Turkish Society of Cardiology
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