ABSTRACT
BACKGROUND:Treadmill testing is the most widely used method for evaluating patients with coronary artery disease. Predicting the left main coronary artery disease (LMCA) before invasive procedure is important in risk assessment because of its grave clinical outcome. Lead aVR can be very useful in identifying LMCAobstruction. It is also valuable lead not only in diagnosis but also predicting the prognosis. AIM: To examine whether STelevation in aVR during TMTcorrelates with LMCAdisease in coronary Angiogram METHOD: In this study 100 patients with positive TMT were included. The study group consisted of 60 patients with ST elevation of > 1mm in aVR. 40 patients also have TMT positive but with < 1mm of ST elevation in aVR is the control group. All patients underwent coronary angiography. RESULTS: Coronary Angiography in the study group revealed significant LMCA disease in 36 (63%) patients whereas no LMCA disease in control group 12 (20%) patients had ostioproximal LAD leisions in study group 4 (10%) patients in the control group. Triple vessel disease in 10 (17%) patients in study group 6 (15%) patients in control group. Since the p value was significant, ST Elevation in aVR during TMT strongly predicts the presence of LMCADisease. CONCLUSION: STsegment elevation in aVR > 1mm during Treadmill testing is a strong predictor of LMCAdisease
ABSTRACT
Background Normally, lead augmented vector right (aVR) has a negative T wave polarity (TaVR) in the electrocardiography (ECG). Positive TaVR and ST segment deviation in lead aVR (STaVR) have negative effects on mortality in heart failure with reduced ejection fraction patients. Aim Our aim was to investigate the relationship between lead aVR changes and mortality in heart failure with preserved ejection fraction (HFpEF) patients. Methods We retrospectively examined 249 patients in 2011–2015 years (mean age 70.8 ± 11.9 years and follow-up period 38.3 ± 9.6 months). ECG, echocardiographic, and laboratory findings were recorded and compared in the study. Existence of positive TaVR, STaVR, and quantitative TaVR values were recorded and the absolute numerical values of TaVR and STaVR were recorded from the 12-lead surface ECG (T/STaVR ratio or vice versa). Results The patients were divided into two groups: living (171) and deceased (78). Age, systolic blood pressure, left atrial diameter, QRS duration, positive TaVR frequency, STaVR, absolute value of TaVR, and ratio were significantly higher in the deceased group. Age (OR: 1.106), STaVR (OR: 2.349), TaVR (OR: 1.612), and T/STaVR ratio (OR: 5.156) were determined as independent predictors for mortality. Conclusions ST segment and T wave polarity changes in lead aVR closely associated with mortality in patients with HfpEF.
ABSTRACT
Objective To investigate the interventional treatment timing of patients with non-ST segment elevation myocar-dial infarction with ST segment elevation in lead aVR.Methods Totally 57 cases with non-ST segment elevation myocardial infarc-tion with ST segment elevation in lead aVR in our hospital from July 2010 to July 2013 were selected.They were divided into two groups,30 cases in group A and they were given emergency PCI treatment with in 12 hours of onset,27 cases in group B and they were given emergency PCI treatment within 12-24 hours of onset.Compare the therapeutic efficacy and adverse cardiovascular e-vents after discharge.Results Therapeutic efficacy of group A was better than group B after 1,6,12 month follow up and rate of adverse cardiovascular events of group A was shorter than group B.Conclusion Emergency PCI treatment within 12 hours can im-prove the prognosis of patients with non-ST segment elevation myocardial infarction with ST segment elevation in lead aVR.