Associations between ECG changes and echocardiographic findings in patients with acute non-ST elevation myocardial infarction

Tuohinen, Suvi; Rankinen, Jani; Skyttä, Tanja; Huhtala, Heini; Virtanen, Vesa; Kellokumpu‐Lehtinen, Pirkko‐Liisa; Raatikainen, Pekka; Nikus, Kjell

doi:10.1016/j.jelectrocard.2017.11.007

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…Our results were supported by Tuohinen et al [8], as they stated that in the STE analysis, when compared with subjects without STD, subjects with STD had prolonged IVRT, lower global early diastolic velocity (e′). STD revealed association with diabetes (r = −0.452, p = 0.045), smoking, and with IVRT.…”

Section: Discussionsupporting

confidence: 89%

“…In the study of Tuohinen et al [8], among their studied cases 45% were hypertensive, 20% of them were diabetics and 30% of them were smokers.…”

Section: Discussionmentioning

confidence: 91%

“…Our results were supported by study of Keddeas et al [7], as they demonstrated that no considerable variation between the two groups regarding LV dimensions was found. However, in the study of Tuohinen et al [8], in comparison with subjects without TWI, subjects with TWI had lower left ventricular ejection fraction (LVEF), (57 ± 6% vs 71 ± 4%, p = 0.008).…”

Section: Discussionmentioning

confidence: 94%

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Speckle Tracking in Acute Non-St Elevation Acute Coronary Syndromes Patients as a Factor of Risk Stratification

Elnemr

Shaaban

El-Hefnawy

et al. 2022

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Background: Coronary artery disease (CAD) early diagnosis remains a clinical problem in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), especially in the regional wall motion abnormalities’ absence on presentation by Echo. This study assessed the relationship between ECG changes and speckle Tracking in subjects with acute NSTE-ACS. Methods: This prospective trial was performed on 100 subjects with NSTE-ACS. All subjects were subjected to laboratory tests [complete blood picture, renal function test, liver test profile, lipid profile, RBS and cardiac biomarkers (cardiac troponin, creatinine kinase and CK-MB)], 12 lead ECG, Echocardiography (TTE, speckle tracking), Image analysis and coronary angiography. Results: regarding IVRT, TDI e`, TDI a`, a considerable difference between the two groups were found. DBP was considerably lower in STD group in comparison with TWI group (P value= 0.047). IVRT, TDI a` and GLS were considerably higher in STD group in comparison with TWI group (P value= 0.024, 0.031, 0.003 respectively). Conclusions: Speckle tracking could be used as part of standard echo for the examination of individuals suffering from NSTE-ACS.

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Section: Discussionsupporting

confidence: 89%

“…In the study of Tuohinen et al [8], among their studied cases 45% were hypertensive, 20% of them were diabetics and 30% of them were smokers.…”

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 94%

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Speckle Tracking in Acute Non-St Elevation Acute Coronary Syndromes Patients as a Factor of Risk Stratification

Elnemr

Shaaban

El-Hefnawy

et al. 2022

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“…within inferoseptal segments of left ventricles which corresponded to radiation treatment elds, 35% of T1 values in this region were greater than 1250 ms, signi cantly greater than in other regions. [43] The most comprehensive study on T1 mapping in the detection of RIHD is also by Takagi et al as There are several limitations to the current study. While RIHD can have many causes, CMR in this study primarily assessed myocardial damage and therefore cardiomyopathy.…”

Section: Studymentioning

confidence: 90%

Cardiac MRI utilizing late gadolinium enhancement (LGE) and T1 mapping in the detection of radiation induced heart disease

Ricco

Slade

Canada

et al. 2020

Preprint

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Abstract Background and Purpose: Radiotherapy has been associated with late dose-dependent cardiovascular toxicity. In this cross-sectional pilot study, radiation dose distributions were correlated with areas of localized and diffuse myocardial fibrosis as measured by novel cardiac MRI (CMR) sequences including late gadolinium enhancement (LGE) and T1 mapping with the goal to identify early markers of myocardial damage.Materials and Methods: Twenty-eight patients with chest tumors including lung, breast, esophagus, and lymphoma underwent CMR per study protocol on average 46.4 months (range 1.7-344.5) after radiotherapy. Patients without pretreatment cardiac history were included if the volume of heart receiving 5 Gy or more was at least 10% (V5Gy≥10%). The association of LGE with cardiac dosimetric factors, clinical factors (e.g., tumor type, smoking history, BMI), , and T1 values was analyzed. Results: Cardiac maximum (Dmax) and mean dose (Dmean) equivalent to doses delivered in 2 Gy fractions (EQD2) were on average 50.9 Gy (range 6.2-108.0) and 8.2 Gy (range 1.0-35.7), respectively, compared to 60.8 Gy (40.8-108.0) and 6.8 Gy (1.8-21.8) among the 9 patients with LGE. Doses were not different between patients with and without LGE (p=0.16 and 0.56, respectively). The average T1 value of the left ventricle myocardium was 1009 ms (range 933-1117). No significant correlation was seen for heart Dmax and Dmean and T1 values (p=0.14 and 0.58, respectively). In addition, no significant association between clinical factors and the development of LGE was identified.Conclusions: No relation between cardiac doses, the presence of LGE or T1 values was observed. Further study is needed to determine the benefit of CMR for detecting radiotherapy-related myocardial fibrosis.

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“…Unlike STEMI, a wide spectrum of ECG changes can be seen in NSTEMI patients each with varying clinical and prognostic implications. 3 Some of the commonly observed ECG patterns in NSTEMI patients include T-wave abnormality, ST-segment depression, non-ischemic abnormality, or transient ST-segment elevation. 3,4 Even though substantial developments have been made in the non-invasive cardiac assessment and diagnostic imaging, ECG remains the most valuable and universally adopted tool.…”

Section: Introductionmentioning

confidence: 99%

Electrocardiogram Changes in Patients with Positive Troponin I Presenting with Non-ST-Elevation Myocardial Infarction

Khowaja

Khan

et al. 2023

Pak Heart J

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Objectives: Unlike “ST-segment elevation myocardial infarction (STEMI)”, there is a wide spectrum of ECG changes for Non-STEMI (NSTEMI) patients with varying prognostic implications. Therefore, the purpose of this study was to determine the frequency of ECG changes in patients with positive high-sensitive troponins (hs-cTn) presenting with NSTEMI. Methodology: This Cross sectional study included 282 patients with positive hs-cTn diagnosed with NSTEMI. Standard 12-lead ECG was performed for all the patients. The clinical profile and ECG changes such as ST elevation in aVR, T wave inversion, and ST depression were noted. Results: Out of 282 patients, 68.1% (192) were male, mean age was 58.5 ± 10.6 years, 56.7% (160) were hypertensive, and 39.7% (112) were diabetic. The ECG was normal in 8.2% (23) while, 64.5% (182) had ST-depression, out of which 1.1% (2) had ST-depression of <1mm, 78% (142) had ST-depression of 1-2mm, and remaining 20.9% (38) had ST-depression of >2mm. T-wave inversions were observed in 45.7% (129). ST-elevation of ≥1 mm in lead aVR was noted in 19.1% (54) patients. Conclusion: A considerable number of NSTEMI patients with positive hs-cTn showed no specific ECG changes. ST-depression followed by T wave inversion and ST-elevation in aVR were the most commonly observed ECG findings in these patients. Considering the prognostic implications and association of these changes with the severity of diseases, prompt decision-making regarding invasive management strategy could be helpful in improving the outcomes of these patients.

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Associations between ECG changes and echocardiographic findings in patients with acute non-ST elevation myocardial infarction

Abstract: The typical ECG changes in NSTEMI patients were associated with subtle echocardiographic changes. STD was related to changes in diastolic function, and TWI was associated with systolic deterioration.

Cited by 10 publications

References 25 publications

Speckle Tracking in Acute Non-St Elevation Acute Coronary Syndromes Patients as a Factor of Risk Stratification

Speckle Tracking in Acute Non-St Elevation Acute Coronary Syndromes Patients as a Factor of Risk Stratification

Cardiac MRI utilizing late gadolinium enhancement (LGE) and T1 mapping in the detection of radiation induced heart disease

Electrocardiogram Changes in Patients with Positive Troponin I Presenting with Non-ST-Elevation Myocardial Infarction

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