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Updated: Aug 30, 2026

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
11:50

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart

Published on: July 9, 2010

Are reciprocal changes a consequence of "ischemia at a distance" or merely a benign electrical phenomenon? A

Sükrü Celik1, Remzi Yilmaz, Merih Baykan

  • 1Department of Cardiology, KTU Faculty of Medicine, Trabzon, Turkey. scelik@meds.ktu.edu.tr

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|October 1, 2003
PubMed

Insights

ST segment depression in precordial leads during inferior myocardial infarction is a reciprocal change, not anterior ischemia. Pulsed-wave tissue Doppler echocardiography confirmed no significant differences in anterior wall diastolic function between groups with and without reciprocal changes.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Echocardiography

Background:

  • The mechanism of reciprocal ST segment depression during acute myocardial infarction remains controversial, with theories including "ischemia at a distance" or benign electrical phenomena.
  • Pulsed-wave tissue Doppler (PWTD) echocardiography offers a method to assess regional left ventricular myocardial wall diastolic motion, potentially detecting ischemic segments.

Purpose of the Study:

  • To investigate whether ST segment depression in precordial leads during acute inferior myocardial infarction signifies a reciprocal change.
  • To differentiate reciprocal ST segment depression from concurrent anterior wall ischemia using surface electrocardiography.

Main Methods:

  • Evaluated regional myocardial ischemia using PWTD echocardiography in 48 patients with first inferior wall myocardial infarction.
  • Divided the left ventricle into 16 segments and obtained PWTD echocardiographic velocities from each segment.

Main Results:

  • No significant differences in systolic (S), early (E), or late (A) diastolic peak velocities, E/A ratio, deceleration time (DT), or relaxation time (RT) were found in the anterior wall between patients with (n=35) and without (n=13) reciprocal ST segment depression.
  • Among patients with reciprocal ST segment depression, anterior wall ischemia was present in 10 and absent in 25; anterior septal ischemia was present in 12 and absent in 23, based on E/A ratio.

Conclusions:

  • Reciprocal ST segment depression observed during the early stages of inferior myocardial infarction is primarily an electrical reflection of the primary ST segment elevation in the infarcted area.
  • This finding suggests that reciprocal ST depression is not indicative of concurrent anterior wall ischemia.
Abstract

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