Increase of R-wave in pre-discharge ergometric test after myocardial infarction indicates advanced left ventricular injury, latent serious arrhythmias and worse prognosis
| Autor: | Leszek Ceremużyński, Andrzej Budaj, Tomasz Chamiec, Dłuzniewski M, Bronisław Bednarz |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart Ventricles Myocardial Infarction Precordial examination Ventricular Function Left Electrocardiography QRS complex Internal medicine medicine Humans In patient cardiovascular diseases Myocardial infarction Aged business.industry Arrhythmias Cardiac Middle Aged Prognosis medicine.disease Echocardiography Exercise Test cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business Holter monitoring Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 42:139-145 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/0167-5273(93)90083-s |
| Popis: | Changes in R-wave amplitude during exercise tests performed soon after myocardial infarction (15-31 days, mean 22) were analyzed in 78 men in relation to left ventricular injury (determined by 2-D echocardiography), ventricular arrhythmias (24-h Holter monitoring) and survival after myocardial infarction. It has been found that in patients with mild left ventricular injury (n = 51, Heger indexor = 3) the sum of the R-wave amplitude in 15 precordial leads recorded immediately after exercise decreased by 3.7 +/- 10% in comparison with resting values. In the patients with major left ventricular injury (n = 26, Heger Index3) the sum of R-wave amplitude after exercise increased by 12.9 +/- 17.5% (P0.001). Positive linear correlation (r = 0.35, P0.01) was observed between the level of left ventricular wall motion disturbances and R-wave amplitude changes. In patients with normal or slightly disturbed cardiac rhythm (n = 42, Lown scale 0-2) the sum of the R-wave amplitude after exercise decreased by 5 +/- 18% as compared to resting values, whereas in the patients with complex arrhythmias (n = 23, Lown scale 3-5) the sum of R-wave amplitude increased amounting to 9.9 +/- 17% (P0.001). Out of 17 patients who died during 5-year follow up, 16 displayed an increase or no change of the sum of R-wave amplitude. The same kind of relations between R-wave amplitude changes and left ventricular injury or cardiac arrhythmias were noted in patients with anterior and inferior myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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