gms | German Medical Science

33. Internationale Konferenz für Elektrokardiographie

Internationale Konferenz für Elektrokardiographie

Judgement of the culprit coronary lesion with electrocardiological examination of the T-wave, in remote non ST-elavation acute coronary syndrome

Meeting Abstract

  • corresponding author presenting/speaker M. Szedlák - Central Hospital of Ministry of the Interior Card, Budapest, Ungarn
  • E. Szücs - Central Military Hospital, Cardiology, Budapest, Ungarn
  • G. Simonyi - Central Hospital of Ministry of the Interior Card, Budapest, Ungarn
  • K. Szakolczai - Research Institute for Technical Physics and Mat., Budapest, Ungarn
  • A. Bolgár - Research Institute for Technical Physics and Mat., Budapest, Ungarn
  • T. Bauernfeind - Cardiovascular Research Group of the Hungarian Ac., Budapest, Ungarn
  • I. Préda - Cardiovascular Research Group of the Hungarian Ac., Budapest, Ungarn
  • M. Medvegy - Central Hospital of Ministry of the Interior Card, Budapest, Ungarn

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice134

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/ice2006/06ice134.shtml

Veröffentlicht: 8. Februar 2007

© 2007 Szedlák et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Non-ST elevation acute coronary syndrome (NSTE) has only seldom ECG changes in its remote state, however in the background there are serious coronary artery lesions. The relationship between the culprit coronary artery lesion and the minor T-wave electrocardiological changes was studied with a quantitative BSPM parameter, which can indicate the anterior and posterior electrical potential loss.

Patients: The culprit lesion was determined concerning the acute-phase-ECG, other non-invasive cardiological examination and the coronary-angiography. 62% of the 66 NSTE-ACS patients had multivessel disease.The culprit lesion was LAD in 25 patients (16 men,41-86, n:63y), right coronary artery (RC) in 32 patients (25 men,43-78, n:61y). 9 patients had circumflex or left main coronary artery disease. Control: 18 (8 men,26-63, n:42y) subjects without any complain and with negative ECG and cardiac echo examination.

Method: Concerning isopotential map series during the T wave, the quotient of the highest maximum and deepest minimum potentials (Max/Min) and its changes after 6 minutes of 0.8 mg subl. nitroglycerine administration (NG) were compared using 63-leads Montreal system BSPM.

Results: The Max/Min value (during the T wave) in the normal group was 2.9±0.8,the change after NG was +3.3±6.2%(NS).The Max/Min value in the LAD group was 1.44±1.45 (difference from normal:p<0.001), its change was significant:+42.8±42.7%(p<0.001). The Max/Min value in the RC group was 3.2±1.3 (no significant difference from the normal), its change after NG:-25.1±20.5%, (p<0.001). The Max/Min change after NG is suitable for separation of the NSTE-ACS patients from normal subjects:concerning ≥14% changing value (independently of its sign) the sensitivity was 70%, the specificity was 100%.

Conclusion: Our BSPM investigation of the T wave can separate the remote NSTE-ACS patients from the healthy subjects and diagnose the LAD or RC culprit coronary lesion in remote NSTE-ACS when the ECG is already not pathological.