Relation of late potentials to ejection fraction and wall motion abnormalities in acute myocardial infarction

J. Anthony Gomes, Steven F. Horowitz, Mark Millner, Josef Machac, Stephen Winters, Phillip Barreca

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

A prospective study was performed to determine the relation between quantitative signal-averaged parameters and ejection fraction (EF) and wall motion abnormalities determined by radionuclide ventriculography in patients with acute myocardial infarction (AMI). In 50 patients with AMI, signal-averaging of the surface QRS complex (200 beats; filter frequencies of 40 to 250 Hz and 80 to 250 Hz) was performed and radionuclide ventriculograms were recorded 8 ± 5 days after AMI. Twenty-five of these patients (50%) had anterior wall AMI, 20 (40%) had inferior wall AMI and 5 (10%) had non-Q-wave AMI. The duration of the low-amplitude signals of less than 40 μV, the signal-averaged QRS complex and the root-mean-square voltage of the terminal 40 ms were determined. In addition to EF determinations, wall motion abnormalities were assessed for the presence or absence of dyskinetic, akinetic and hypokinetic segments. A wall motion score was constructed by separating the left and right ventricles into 21 segments in the anterior, left anterior oblique and lateral views. On the basis of the presence or absence of late potentials, the patients were separated into 2 groups: group I comprised 15 patients (30%) with late potentials and group II 35 patients (70%) without late potentials. The low-amplitude signals (49 ± 12 vs 24 ± 8 ms) and the signal-averaged QRS complex (122 ± 20 vs 96 ± 15 ms) were significantly longer and the root-mean-square voltage (13.8 ± 4.9 vs 54.3 ± 27.4 μV) significantly lower in group I than in group II. However, EF (38 ± 14% vs 36 ± 12%), left and right ventricular wall motion abnormalities and left and right ventricular as well as combined wall motion scores were not significantly different between the groups. Thus, abnormal signal-averaged parameters are seen in 30% of patients with AMI and are independent of EF and wall motion abnormalities, and they may have independent prognostic value in patients who have had infarction.

Original languageEnglish (US)
Pages (from-to)1071-1074
Number of pages4
JournalThe American Journal of Cardiology
Volume59
Issue number12
DOIs
StatePublished - May 1 1987
Externally publishedYes

Fingerprint

Myocardial Infarction
Heart Ventricles
Anterior Wall Myocardial Infarction
Radionuclide Ventriculography
Inferior Wall Myocardial Infarction
Radioisotopes
Infarction
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Gomes, J. Anthony ; Horowitz, Steven F. ; Millner, Mark ; Machac, Josef ; Winters, Stephen ; Barreca, Phillip. / Relation of late potentials to ejection fraction and wall motion abnormalities in acute myocardial infarction. In: The American Journal of Cardiology. 1987 ; Vol. 59, No. 12. pp. 1071-1074.
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abstract = "A prospective study was performed to determine the relation between quantitative signal-averaged parameters and ejection fraction (EF) and wall motion abnormalities determined by radionuclide ventriculography in patients with acute myocardial infarction (AMI). In 50 patients with AMI, signal-averaging of the surface QRS complex (200 beats; filter frequencies of 40 to 250 Hz and 80 to 250 Hz) was performed and radionuclide ventriculograms were recorded 8 ± 5 days after AMI. Twenty-five of these patients (50{\%}) had anterior wall AMI, 20 (40{\%}) had inferior wall AMI and 5 (10{\%}) had non-Q-wave AMI. The duration of the low-amplitude signals of less than 40 μV, the signal-averaged QRS complex and the root-mean-square voltage of the terminal 40 ms were determined. In addition to EF determinations, wall motion abnormalities were assessed for the presence or absence of dyskinetic, akinetic and hypokinetic segments. A wall motion score was constructed by separating the left and right ventricles into 21 segments in the anterior, left anterior oblique and lateral views. On the basis of the presence or absence of late potentials, the patients were separated into 2 groups: group I comprised 15 patients (30{\%}) with late potentials and group II 35 patients (70{\%}) without late potentials. The low-amplitude signals (49 ± 12 vs 24 ± 8 ms) and the signal-averaged QRS complex (122 ± 20 vs 96 ± 15 ms) were significantly longer and the root-mean-square voltage (13.8 ± 4.9 vs 54.3 ± 27.4 μV) significantly lower in group I than in group II. However, EF (38 ± 14{\%} vs 36 ± 12{\%}), left and right ventricular wall motion abnormalities and left and right ventricular as well as combined wall motion scores were not significantly different between the groups. Thus, abnormal signal-averaged parameters are seen in 30{\%} of patients with AMI and are independent of EF and wall motion abnormalities, and they may have independent prognostic value in patients who have had infarction.",
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Relation of late potentials to ejection fraction and wall motion abnormalities in acute myocardial infarction. / Gomes, J. Anthony; Horowitz, Steven F.; Millner, Mark; Machac, Josef; Winters, Stephen; Barreca, Phillip.

In: The American Journal of Cardiology, Vol. 59, No. 12, 01.05.1987, p. 1071-1074.

Research output: Contribution to journalArticle

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