Higher Gensini Score of Coronary Arteries in Acute Inferior Myocardial Infarction with Precordial ST-Segment Depression.
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概要
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To investigate the significance of precordial ST-segment depression in acute inferior myocardial infarction, we compared the Gensini score of coronary artery stenosis between 2 groups of patients with and without precordial ST-segment depression. Group I consisted of 28 patients who showed ST-segment depression on admission (≥1mm in V2-V6) and Group II (n=16) those without ST-segment depression (<1mm). The Gensini score of the coronary arteries (56±29 vs. 28±18; p<0.001), the partial score of the infarction-related artery (29±16 vs. 17±11; p<0.01) and of the infarction-nonrelated artery (27±24 vs. 11±12; p<0.02) were significantly higher in Group I than in Group II. The Killip score (≥II) (34% vs. 6%; p<0.05), frequency of arrhythmias (75% vs. 38%; p<0.02) and peak CK value (3, 676±2, 290 vs. 1, 818±1, 153 IU/L; p<0.005) were higher in Group I than in Group II. Four patients in Group I died following admission, while no patient died in Group II (N.S.). Autopsy findings from the 4 Group I patients revealed fresh extensive inferior infarction and healed diffuse subendocardial infarction which could not be predicted from electrocardiograms.All patients who survived the acute stage performed treadmill exercise testing and 22 patients underwent exercise thallium-201 single photon emission computer tomography (SPECT). On treadmill exercise test, there was no significant difference between the 2 groups in the frequency of angina pectoris and ST-segment depression. On SPECT, the perfusion defect area under 55% of maximum uptake at the redistribution phase was 45.8±19.6cm2 in Group I (n=14) and 34.7±21.3cm2 in Group II (n=8; N.S.).In conclusion, precordial ST-segment depression in acute inferior myocardial infarction suggested advanced atherosclerosis in both the infarction-related and nonrelated coronary arteries, indicating a larger infarct size.
- International Heart Journal刊行会の論文
著者
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Takayanagi Kan
Department Of Cardiology Dokkyo Medical University Koshigaya Hospital
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Takabatake Yutaka
Department Of Cardiology Dokkyo University School Of Medicine Koshigaya Hospital
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YAMAGUCHI Hirokazu
Department of Cardiology Dokkyo University School of Medicine, Koshigaya Hospital
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Morooka Shigenori
Department Of Cardiology Dokkyo University School Of Medicine Koshigaya Hospital
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