The relationship between the electrocardiographically estimated infarct size and 1 ‐ and 2‐year survival in acute myocardial infarction

Abstract

Summary:In 587 patients with acute myocardial infarction (AMI) and no previous MI, electrocardiographically estimated infarct size was related to 1-and 2-year mortality. The overall mortality was higher in patients with transmural MI (Q-or R-wave changes in standard ECG) than in patients with subendocardial infarction (ST-Twave changes in standard ECG) after 1 year (18.8% compared to 6.5% p<O.OOl) and after 2 years (22.2% compared to 13.8%, p=0.049). When patients who were alive during primary hospitalization were analyzed separately, slightly higher mortality was found in patients with transmural MI than in subendocardial MI after 1 year (9.6% compared to 4.2%, p=0.076) while no difference was found after 2 years (13.4% as compared to 1 1.7%, p>0.2). In a subgroup of patients with anterior MI, precordial mapping with 24 chest leads was analyzed 4 days after arrival in hospital (n=197). Patients were divided into quartiles according to the sum of R waves, the sum of Q waves, and the number of Q waves. There was a similar overall mortality in each quartile after 1 year and after 2 years regardless of ECG parameters studied. Neither did we find any correlation between the sum of R waves in leads 11, 111, and aVF on the fourth day in patients with inferior MI and overall 1 -or 2-year mortality rate, although there was a trend towards higher mortality with more ECG changes.

Appearance of T‐Wave inversions without raised serum enzyme activity in suspected acute myocardial infarction: Clinical outcome in relation to subendocardial infarction

“…, 1984b) but have a lower incidence of angina pectoris during follow-up (Cannom et a f . , 1976;Herlitz et al, 1985). Not surprisingly, patients with possible infarction had less signs of congestive heart failure during initial hospitalization.…”

“…During the last decade there has been a debate as to whether different types of infarctions have a different prognosis (Cannom et al, 1976;Herlitz et al, 1984a;Thanavaro et al, 1980) and a different morbidity pattern (Cannom et al, 1976;Herlitz et al, 1985). There have also been studies comparing the outcome of patients who turned out to have no confirmed infarction with the outcome of those who had a confirmed infarction (Hovendahl 1971;Moms et al, 1983;Schroeder et al, 1980).…”

Enhancing the Accuracy of Computerized Interpretation of Old Inferior Wall Myocardial Infarction in a Routine or Preoperative Electrocardiogram by Analyzing Repolarization Abnormalities and Q Waves in Leads II, III and aVF

“…Pathologic Q waves are related to the size of the MI [8,9]. Large MIs which involve more than 10% of the ventricular myocardium often exhibit significant Q waves, while small infarcts may occur without leaving residual pathologic Q waves on electrocardiogram [10].…”