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Correlation between the electrocardiogram and regional wall motion abnormalities as detected by echocardiography in
Gregory Golovchiner1, Israel Matz, Zaza Iakobishvili
1Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
ST deviation in precordial ECG leads correlates with regional wall motion abnormalities in acute myocardial infarction. Specific ECG patterns predict specific cardiac segment damage, aiding diagnosis and risk assessment.
Area of Science:
- Cardiology
- Medical Imaging
- Electrocardiography
Background:
- Acute myocardial infarction (AMI) diagnosis relies on ECG and echocardiography.
- Regional wall motion abnormalities (RWMA) indicate myocardial damage extent.
- Correlating ECG findings with RWMA can improve diagnostic accuracy.
Purpose of the Study:
- To assess the correlation between ST deviation in precordial ECG leads and RWMA in patients with inferior AMI.
- To determine the diagnostic value of specific ST deviation patterns for identifying affected cardiac segments.
Main Methods:
- Retrospective analysis of 109 patients with first inferior AMI.
- ECG analysis of ST deviation in precordial leads (V1-V6).
- Transthoracic echocardiography to assess RWMA and global RWMA score.
Main Results:
- ST depression in V1/V2 correlated with mid-posterior segment RWMA (sensitivity 36-70%, specificity 57-87%).
- ST depression in V2/V3 linked to worse global RWMA scores.
- ST elevation in V1 indicated right ventricular involvement; ST elevation in V5/V6 associated with inferior wall/mid-posterior segment RWMA and worse global scores.
Conclusions:
- Precordial ST deviation patterns are valuable indicators of RWMA in inferior AMI.
- Specific ECG findings can predict the location and extent of myocardial damage.
- ECG-echocardiography correlation aids in comprehensive AMI assessment.
Abstract:
We assessed the correlation between ST deviation in each of the six precordial leads and the presence of regional wall motion abnormalities (RWMA) as assessed by transthoracic echocardiography in 109 patients with first inferior acute myocardial infarction. ST depression in lead V1 and V2 was associated with higher incidence of RWMA of the mid-posterior segment (p < 0.02 for both leads). The specificity of ST segment depression in leads V1 and V2 for RWMA in mid-posterior segment was 87 and 57%, and the sensitivity 36 and 70%, respectively. Patients with ST depression in leads V2 or V3 had worse global RWMA score than patients without ST depression in these leads (p = 0.009 and p = 0.025, respectively). Patients with an ST elevation in lead V1, but not in leads V2 or V3, had a higher prevalence of right ventricular involvement (p < 0.0001). ST elevation in lead V5 was associated with more frequent involvement of the apical portion of the inferior wall (p < 0.02), with specificity of 88% and sensitivity of 33%. Global RWMA score was significantly worse for patients with ST elevation than for patients with isoelectric ST in lead V5 (p = 0.024). ST elevation in lead V6 was associated with RWMA in the mid-posterior segment (p < 0.006), with specificity of 91% and sensitivity of 33%, and worse global RWMA score (p = 0.022).
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