TY - JOUR
T1 - Accuracy of localization of acute myocardial infarctionby 12 lead electrocardiography
AU - Yasuda, Tsunehiro
AU - Ribeiro, Lair G.T.
AU - Holman, B. Leonard
AU - Alpert, Joseph S.
AU - Maroko, Peter R.
N1 - Funding Information:
From Deborah Heart and Lung Center, Browns Mills, NJ and the Departments of Medicine and Radiology, Harvard Medical School and Peter Bent Brigham Hospital, Boston, MA This study was supported by USPHS Contract N01 HV 53000 and USPHS Grant GM 18674. *Assistant Professor at Massachusetts General ttospital, Harvard Medical School, Boston, MA. *Assistant Director of Deborah Cardiovascular Research Institute, Browns Mills, NJ. **Director of the Clinical Nuclear Medicine Service, Peter Bent Brigham Hospital, Boston MA. tt Chief of Cardiology at University of Massachusetts Medical Center, Worcester, MA. ***Director of the Deborah Cardiovascular Research Institute, Browns Mills, NJ. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. w 1734 solely to indicate this fact. Reprint requests to: Peter R. Maroko, M.D., The Deborah Cardiovascular Research Institute, 1 Trenton Road, Browns Mills, New Jersey 08015.
PY - 1982
Y1 - 1982
N2 - Until recently, ECG accuracy in localizing acute myocardial infarction (AMI) could be assessed only be comparing the ECGs with autopsy findings. This approach, however, preselected patients, including only those who died. It is possible that this postmortem group of patients would be different from the whole population of patients with AMI. Myocardial imaging with 99mTc-pyrophosphate offers the advantage of directly localizing the region of injured myocardium in the acute phase of AMI. In 34 patients with confirmed AMI and focal uptake of 99mTc-pyrophosphate, serial ECGs were obtained and interpreted by two independent observers. The sensitivity and specificity of serial ECGs in determining the location of AMI in the five left ventricular (LV) wall segments were determined: (1) in the anterior wall sensitivity was 86.7% and specificity was 89.5%; (2) in the lateral wall sensitivity was 73.7% and specificity was 80.0%; (3) in the high lateral wall sensitivity was 80.0% and specificity was 87.5%; (4) in the inferior wall sensitivity was 87.5% and specificity was 100%; (5) in the "true" posterior wall sensitivity was 83.3% and specificity was 86.4%. Overall, in the 170 LV wall segments (five per patient) examined, scans localized with a sensitivity of 81.9% and a specificity of 88.8%. After four patients with LBBB were excluded, sensitivity increased to 87.1%. Overall, localization of AMI by serial ECG was accurate in 85.9% of the 34 patients included in the study.
AB - Until recently, ECG accuracy in localizing acute myocardial infarction (AMI) could be assessed only be comparing the ECGs with autopsy findings. This approach, however, preselected patients, including only those who died. It is possible that this postmortem group of patients would be different from the whole population of patients with AMI. Myocardial imaging with 99mTc-pyrophosphate offers the advantage of directly localizing the region of injured myocardium in the acute phase of AMI. In 34 patients with confirmed AMI and focal uptake of 99mTc-pyrophosphate, serial ECGs were obtained and interpreted by two independent observers. The sensitivity and specificity of serial ECGs in determining the location of AMI in the five left ventricular (LV) wall segments were determined: (1) in the anterior wall sensitivity was 86.7% and specificity was 89.5%; (2) in the lateral wall sensitivity was 73.7% and specificity was 80.0%; (3) in the high lateral wall sensitivity was 80.0% and specificity was 87.5%; (4) in the inferior wall sensitivity was 87.5% and specificity was 100%; (5) in the "true" posterior wall sensitivity was 83.3% and specificity was 86.4%. Overall, in the 170 LV wall segments (five per patient) examined, scans localized with a sensitivity of 81.9% and a specificity of 88.8%. After four patients with LBBB were excluded, sensitivity increased to 87.1%. Overall, localization of AMI by serial ECG was accurate in 85.9% of the 34 patients included in the study.
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U2 - 10.1016/S0022-0736(82)80014-9
DO - 10.1016/S0022-0736(82)80014-9
M3 - Article
C2 - 6279750
AN - SCOPUS:0020079179
SN - 0022-0736
VL - 15
SP - 181
EP - 188
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 2
ER -