Reciprocal ST-segment changes in acute myocardial infarction

ABSTRACT

The presence of ST depression in electrocardiogram of a patient with STEMI may represent a reciprocal electrical effect or true remote ischemia, which has prognostic value. This study was conducted to investigate the relationship between ischemic regions through coronary angiographic findings with reciprocal ST-segment changes in acute myocardial infarction. From March 2007 to May 2008, 55 consecutive patients with diagnosis of acute myocardial infarction who had reciprocal ST depressions in electrocardiogram and were candidate for coronary angiography were recruited in our study. The amount of ST-segment depression at 0.08 seconds after the J point in the reciprocal leads on admission 12-lead electrocardiograms of the patients were evaluated for the quantification of reciprocal ST depressions [mm]. Twenty five of 55 patients had anterior [45.5%] and 30 patients had inferior MI [54.5%].In inferior MI with 1VD, mean ST depression to mean ST elevation was 1.4. In inferior MI with multi vessel disease, mean ST depression to mean ST elevation was 2. In anterior MI with 1VD, mean ST depression to mean ST elevation was o.25. In anterior MI with multi vessel disease, mean ST depression to mean ST elevation was 0.48. Our result demonstrated a significant positive linear correlation between ST Depression/ST Elevation and the site and number of vessels with occlusion, indicating severe reciprocal ST depressions as a marker of extensive coronary artery disease