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 Koc11
Health Sciences University Adana Health Practices and Research Center Cardiology Department2
Health Sciences University Adana Health Practices and Research Center Radiology Department
OBJECTIVE We aimed to investigate the relationship between ischemic changes in lead aVR and left ventricular thrombus (LVT) or high-grade spontaneous echo contrast in patients with acute anterior myocardial infarction (MI).
METHODS Quantitative T wave polarity in lead aVR (TPaVR) and ST segment deviation in lead aVR (STaVR) measured from surface ECG, and the absolute numerical values of those were recorded. ST/TPaVR ratio was obtained from the division of larger absolute value by smaller. Presence of LVT or high-grade SEC were recorded from echocardiograpy. Syntax score (SS), clinical SS (cSS), and residual SS (rSS) were calculated from angiography.
RESULTS 34 patients were included with LVT or high-grade SEC and named as group 1. 170 patients did not have any LVT or high-grade SEC and these patients named as group 2. P wave duration, V2 ST-segment elevation, TPaVR, cSS, and ST/TPaVR ratio were significantly higher in the group 1. EF and STaVR were significantly higher in the group 2. EF (OR: 0.9, 95% CI: 0.833-0.973, p=0.008), TPaVR (OR: 1.454) and ST/TPaVR ratio (OR: 1.454, 95% CI: 1.074-1.967, p=0.015) were detected as independent predictors for group 1.
CONCLUSIONS Ischemic changes in lead aVR is closely associated with LVT or high-grade in anterior MI patients.
Myocardial infarction, left ventricular thrombus, lead aVR.
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Corresponding Author: Yahya Kemal Içen, Türkiye