[Relationship between the ECG and MRI findings in acute myocardial infarction]
Gabriela Meléndez-Ramírez1, Alfredo de Micheli, Víctor Fratti
1Departamento de Resonancia Magnética.
Insights
Electrocardiogram (ECG) leads showing ST elevation accurately identify myocardial segments with edema in ST-elevation myocardial infarction (STEMI) patients, as confirmed by cardiac MRI. This correlation aids in pinpointing infarct-related areas.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Objective:
To evaluate the agreement between de ECG leads with ST elevation and the myocardial segments that present myocardial edema in the MRI study, in patients with acute myocardial infarction.
Methods:
There were included 91 patients with a first ST elevation myocardial infarction (STEMI) with reperfusion therapy during the first 12 hours of onset symptoms, in whom a Cardiovascular Magnetic Resonance (CMR) was done (mean 3 day after the ischemic event). Among the ECG leads (thoracic circle), there were identified those with ST higher elevation. In the CMR there were evaluated the myocardial segments with edema (T2-weighted sequence with hyperintensity).
Results:
The ECG leads with the best sensibility in the detection of injury, corresponding to cellular edema, were: basal anterior and anteroseptal: V2; basal inferoseptal LIII and aVF; basal inferior and inferolateral: LIII; basal anterolateral V7-V9; mid anterior and anteroseptal:V2 and V3; mid inferoseptal, inferior and inferolateral: LIII and aVF; mid anterolateral V2 and V8; apical anterior and septal: V2-V4; apical inferior and lateral: LII, LIII and aVF; apex: V2-V4.
Conclusions:
The surface ECG leads with higher ST elevation corresponded to the myocardial segments with more important edema (defined as someone with hyperintensity in the T2- weighted MRI sequence).
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