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Hanjörg Just - One of the best experts on this subject based on the ideXlab platform.

  • Eligibility for and benefit of thrombolytic therapy in Inferior Myocardial Infarction: Focus on the prognostic importance of right ventricular Infarction☆
    Journal of the American College of Cardiology, 1994
    Co-Authors: Manfred Zehender, Wolfgang Kasper, Elisabeth Kauder, Martin Schonthaler, Annette Geibel, Manfred Olschewski, Hanjörg Just
    Abstract:

    Objectives. This study was undertaken to determine eligibility for and benefit of thrombolytic therapy in patients with acute Inferior Myocardial Infarction with or without right ventricular involvement. Background. Right ventricular involvement commonly complicates acute Inferior myocardlal Infarction and is considered to have prognostic relevance. We hypothesized that the presence of right ventricular Infarction, diagnosed early by ST segment elevation in the right precordial lead (V4R), may be of clinical importance in identifying patients who will benefit most from thrombolytic therapy. Methods. We studied 200 consecutive patients with acute Inferior Myocardial Infarction to assess the prognostic impact of right ventricular Infarction in those considered eligible or ineligible for reperfusion therapy. Prognostic analyses were based on the in-hospital period and a 1- to 6-year follow-up (mean [±SD] 37 ± 12 months). Results. ST segment elevation in lead V4R was a reliable marker of right ventricular Infarction (sensitivity 88%, specificity 78%, diagnostic efficiency 83%) in 107 patients (54%) with Inferior Myocardial Infarction. Seventy-one eligible patients (36%) received thrombolytic therapy and had a lower mortality (8% [6 of 71]) and complication (31% [22 of 71]) rate than ineligible patients (mortality rate 25% [32 of 129], p < 0.001; complication rate 56% [72 of 129], p < 0.01). However, the overall benifit of thrombolysis was restricted to patients with right ventricular Infarction complicating acute Inferior Myocardial Infarction (with vs. without thrombolysis, respectively: mortality rate 10% vs. 42%, p < 0.005; complication rate 34% vs. 54%, p < 0.05). In the absence of right ventricular Infarction, no difference was observed in the mortality (7% vs. 6%, p = NS) and major in-hospital complication (27% vs. 29%, p = NS) rates, whether or not the patient underwent thrombolytic therapy. Posthospital course over 37 ± 12 months was not different in patients with and without right ventricular Infarction but was best in all patients considered for reperfusion therapy. Conclusions. During acute Inferior Myocardial Infarction, the right precordial electrocardiogram is a simple but promising variable to identify a subgroup of patients with an unfavorable course who will benefit most from thrombolytic therapy.

  • Right Ventricular Infarction as an Independent Predictor of Prognosis after Acute Inferior Myocardial Infarction
    The New England journal of medicine, 1993
    Co-Authors: Manfred Zehender, Wolfgang Kasper, Elisabeth Kauder, Martin Schonthaler, Annette Geibel, Manfred Olschewski, Hanjörg Just
    Abstract:

    Background Acute Inferior Myocardial Infarction frequently involves the right ventricle. We hypothesized that right ventricular involvement, as diagnosed by ST-segment elevation in the right precordial lead V4R, may affect the prognosis of patients with Inferior Myocardial Infarctions. Methods In 200 consecutive patients admitted to the hospital with acute Inferior Myocardial Infarctions, we assessed the prevalence and diagnostic accuracy of ST-segment elevation in lead V4R (as compared with four other diagnostic procedures) to identify right ventricular involvement and its prognostic implications for in-hospital and long-term outcomes. Results The in-hospital mortality after Inferior Myocardial Infarction was 19 percent, and major complications occurred in 47 percent of the patients. The presence of ST-segment elevation in lead V4R in 107 patients (54 percent) was highly predictive of right ventricular Infarction (sensitivity, 88 percent; specificity, 78 percent; diagnostic accuracy, 83 percent), as comp...

Manfred Zehender - One of the best experts on this subject based on the ideXlab platform.

  • Eligibility for and benefit of thrombolytic therapy in Inferior Myocardial Infarction: Focus on the prognostic importance of right ventricular Infarction☆
    Journal of the American College of Cardiology, 1994
    Co-Authors: Manfred Zehender, Wolfgang Kasper, Elisabeth Kauder, Martin Schonthaler, Annette Geibel, Manfred Olschewski, Hanjörg Just
    Abstract:

    Objectives. This study was undertaken to determine eligibility for and benefit of thrombolytic therapy in patients with acute Inferior Myocardial Infarction with or without right ventricular involvement. Background. Right ventricular involvement commonly complicates acute Inferior myocardlal Infarction and is considered to have prognostic relevance. We hypothesized that the presence of right ventricular Infarction, diagnosed early by ST segment elevation in the right precordial lead (V4R), may be of clinical importance in identifying patients who will benefit most from thrombolytic therapy. Methods. We studied 200 consecutive patients with acute Inferior Myocardial Infarction to assess the prognostic impact of right ventricular Infarction in those considered eligible or ineligible for reperfusion therapy. Prognostic analyses were based on the in-hospital period and a 1- to 6-year follow-up (mean [±SD] 37 ± 12 months). Results. ST segment elevation in lead V4R was a reliable marker of right ventricular Infarction (sensitivity 88%, specificity 78%, diagnostic efficiency 83%) in 107 patients (54%) with Inferior Myocardial Infarction. Seventy-one eligible patients (36%) received thrombolytic therapy and had a lower mortality (8% [6 of 71]) and complication (31% [22 of 71]) rate than ineligible patients (mortality rate 25% [32 of 129], p < 0.001; complication rate 56% [72 of 129], p < 0.01). However, the overall benifit of thrombolysis was restricted to patients with right ventricular Infarction complicating acute Inferior Myocardial Infarction (with vs. without thrombolysis, respectively: mortality rate 10% vs. 42%, p < 0.005; complication rate 34% vs. 54%, p < 0.05). In the absence of right ventricular Infarction, no difference was observed in the mortality (7% vs. 6%, p = NS) and major in-hospital complication (27% vs. 29%, p = NS) rates, whether or not the patient underwent thrombolytic therapy. Posthospital course over 37 ± 12 months was not different in patients with and without right ventricular Infarction but was best in all patients considered for reperfusion therapy. Conclusions. During acute Inferior Myocardial Infarction, the right precordial electrocardiogram is a simple but promising variable to identify a subgroup of patients with an unfavorable course who will benefit most from thrombolytic therapy.

  • Right Ventricular Infarction as an Independent Predictor of Prognosis after Acute Inferior Myocardial Infarction
    The New England journal of medicine, 1993
    Co-Authors: Manfred Zehender, Wolfgang Kasper, Elisabeth Kauder, Martin Schonthaler, Annette Geibel, Manfred Olschewski, Hanjörg Just
    Abstract:

    Background Acute Inferior Myocardial Infarction frequently involves the right ventricle. We hypothesized that right ventricular involvement, as diagnosed by ST-segment elevation in the right precordial lead V4R, may affect the prognosis of patients with Inferior Myocardial Infarctions. Methods In 200 consecutive patients admitted to the hospital with acute Inferior Myocardial Infarctions, we assessed the prevalence and diagnostic accuracy of ST-segment elevation in lead V4R (as compared with four other diagnostic procedures) to identify right ventricular involvement and its prognostic implications for in-hospital and long-term outcomes. Results The in-hospital mortality after Inferior Myocardial Infarction was 19 percent, and major complications occurred in 47 percent of the patients. The presence of ST-segment elevation in lead V4R in 107 patients (54 percent) was highly predictive of right ventricular Infarction (sensitivity, 88 percent; specificity, 78 percent; diagnostic accuracy, 83 percent), as comp...

Chen Hua-f - One of the best experts on this subject based on the ideXlab platform.

  • The relationship between the ratio of ST segment changes and infarct-related artery in acute Inferior Myocardial Infarction
    Hainan Medical Journal, 2011
    Co-Authors: Chen Hua-f
    Abstract:

    Objective To investigate the relationship between the ratio of ST segment changes and infarct-related artery in acute Inferior Myocardial Infarction. Methods The ratio of ECG I, Ⅱ, Ⅲ, aVL ,V3ST ST segment changes in 87 cases with acute Inferior Myocardial Infarction was analyzed, then compared with coronary angiography. Results There were 70 cases with infarct-related artery (IRA) were the right coronary artery (RCA) (80.5%), and 17 cases were left coronary circumflex artery (LCX) (19.5%). ST↑Ⅲ/ST↑Ⅱ1,ST↓aVL/ST↓Ⅰ1,ST↓V3/ ST↑Ⅲ≤1.2 prompts IRA as RCA, with higher sensitivity and specificity, and the highest positive predictive value (PPV); ST↑Ⅲ/ST↑Ⅱ≤1, ST↓aVL/ST↓Ⅰ≤1,ST↓V3/ ST↑Ⅲ1.2 prompts IRA to LCX, with higher negative predictive value (NPV), the difference was statistically significant (P0.01). Conclusion RCA is the main infarct-related artery in acute Inferior Myocardial Infarction, and the radio of ST segment changes can predict Infarction-related artery in acute Inferior Myocardial .

Harvey D. White - One of the best experts on this subject based on the ideXlab platform.

  • Prognostic Value of Lead V1 ST Elevation During Acute Inferior Myocardial Infarction
    Circulation, 2010
    Co-Authors: Cheuk Kit Wong, Wanzhen Gao, Ralph A.h. Stewart, John K. French, Philip E. Aylward, Jocelyne Benatar, Harvey D. White
    Abstract:

    Background—Lead V1 directly faces the right ventricle and may exhibit ST elevation during an acute Inferior Myocardial Infarction when the right ventricle is also involved. Leads V1 and V3 indirectly face the posterolateral left ventricle, and ST depression (“mirror-image” ST elevation) in V1 through V3 may reflect concomitant posterolateral Infarction. The prognostic significance of V1 ST elevation during an acute Inferior Myocardial Infarction may therefore be dependent on V3 ST changes. Methods and Results—In 7967 patients with acute Inferior Myocardial Infarction in the Hirulog and Early Reperfusion or Occlusion-2 (HERO-2) trial, V1 ST levels were analyzed with adjustment for lead V3 ST level for predicting 30-day mortality. V1 ST elevation at baseline, analyzed as a continuous variable, was associated with higher mortality. Unadjusted, each 0.5-mm-step increase in ST level above the isoelectric level was associated with ≈25% increase in 30-day mortality; this was true whether V3 ST depression was pre...

Wolfgang Kasper - One of the best experts on this subject based on the ideXlab platform.

  • Eligibility for and benefit of thrombolytic therapy in Inferior Myocardial Infarction: Focus on the prognostic importance of right ventricular Infarction☆
    Journal of the American College of Cardiology, 1994
    Co-Authors: Manfred Zehender, Wolfgang Kasper, Elisabeth Kauder, Martin Schonthaler, Annette Geibel, Manfred Olschewski, Hanjörg Just
    Abstract:

    Objectives. This study was undertaken to determine eligibility for and benefit of thrombolytic therapy in patients with acute Inferior Myocardial Infarction with or without right ventricular involvement. Background. Right ventricular involvement commonly complicates acute Inferior myocardlal Infarction and is considered to have prognostic relevance. We hypothesized that the presence of right ventricular Infarction, diagnosed early by ST segment elevation in the right precordial lead (V4R), may be of clinical importance in identifying patients who will benefit most from thrombolytic therapy. Methods. We studied 200 consecutive patients with acute Inferior Myocardial Infarction to assess the prognostic impact of right ventricular Infarction in those considered eligible or ineligible for reperfusion therapy. Prognostic analyses were based on the in-hospital period and a 1- to 6-year follow-up (mean [±SD] 37 ± 12 months). Results. ST segment elevation in lead V4R was a reliable marker of right ventricular Infarction (sensitivity 88%, specificity 78%, diagnostic efficiency 83%) in 107 patients (54%) with Inferior Myocardial Infarction. Seventy-one eligible patients (36%) received thrombolytic therapy and had a lower mortality (8% [6 of 71]) and complication (31% [22 of 71]) rate than ineligible patients (mortality rate 25% [32 of 129], p < 0.001; complication rate 56% [72 of 129], p < 0.01). However, the overall benifit of thrombolysis was restricted to patients with right ventricular Infarction complicating acute Inferior Myocardial Infarction (with vs. without thrombolysis, respectively: mortality rate 10% vs. 42%, p < 0.005; complication rate 34% vs. 54%, p < 0.05). In the absence of right ventricular Infarction, no difference was observed in the mortality (7% vs. 6%, p = NS) and major in-hospital complication (27% vs. 29%, p = NS) rates, whether or not the patient underwent thrombolytic therapy. Posthospital course over 37 ± 12 months was not different in patients with and without right ventricular Infarction but was best in all patients considered for reperfusion therapy. Conclusions. During acute Inferior Myocardial Infarction, the right precordial electrocardiogram is a simple but promising variable to identify a subgroup of patients with an unfavorable course who will benefit most from thrombolytic therapy.

  • Right Ventricular Infarction as an Independent Predictor of Prognosis after Acute Inferior Myocardial Infarction
    The New England journal of medicine, 1993
    Co-Authors: Manfred Zehender, Wolfgang Kasper, Elisabeth Kauder, Martin Schonthaler, Annette Geibel, Manfred Olschewski, Hanjörg Just
    Abstract:

    Background Acute Inferior Myocardial Infarction frequently involves the right ventricle. We hypothesized that right ventricular involvement, as diagnosed by ST-segment elevation in the right precordial lead V4R, may affect the prognosis of patients with Inferior Myocardial Infarctions. Methods In 200 consecutive patients admitted to the hospital with acute Inferior Myocardial Infarctions, we assessed the prevalence and diagnostic accuracy of ST-segment elevation in lead V4R (as compared with four other diagnostic procedures) to identify right ventricular involvement and its prognostic implications for in-hospital and long-term outcomes. Results The in-hospital mortality after Inferior Myocardial Infarction was 19 percent, and major complications occurred in 47 percent of the patients. The presence of ST-segment elevation in lead V4R in 107 patients (54 percent) was highly predictive of right ventricular Infarction (sensitivity, 88 percent; specificity, 78 percent; diagnostic accuracy, 83 percent), as comp...