Clinical Value of Limb-Lead R-Wave Amplitude in Predicting Cardiac Rupture After Acute Anterior Myocardial Infarction...

Area of Science:

• Cardiology
• Electrocardiography
• Myocardial Infarction

Background:

• Cardiac rupture is a fatal complication of acute anterior myocardial infarction (AAMI), particularly in patients with left ventricular aneurysm (LVA).
• Identifying high-risk patients for cardiac rupture is crucial for timely intervention.

Purpose of the Study:

• To evaluate the predictive value of average R-wave voltage in limb leads (AVRE) for cardiac rupture in AAMI patients with LVA.
• To assess the utility of AVRE as a risk stratification tool in this specific population.

Main Methods:

• Retrospective single-center study of 249 AAMI patients undergoing primary PCI.
• Comparison of 63 patients with cardiac rupture (CR group) versus 186 without (Control group).
• AVRE measured on admission ECG; multivariate logistic regression and ROC analysis used for prediction.

Main Results:

• Patients with cardiac rupture had significantly lower AVRE (2.33 mV) than controls (3.33 mV).
• Reduced AVRE (<2.92 mV) was an independent predictor of cardiac rupture (OR: 0.682, p<0.01).
• AVRE showed significant predictive performance (AUC: 0.656) with 74.6% sensitivity and 59.7% specificity.

Conclusions:

• Reduced AVRE is an independent predictor of cardiac rupture in AAMI patients with LVA.
• AVRE serves as an accessible and valuable tool for risk stratification in this high-risk cohort.