The Relationship of the Changes in Lateral Leads I and AVL in Electrocardiogram with Echocardiography and Coronary Angiography Findings in Patients with Acute Coronary Syndrome

Overview

Journal ARYA Atheroscler

Date 2022 Jun 10

PMID 35685823

Authors

Hasan Shemirani

Farzad Mir-Amirkhani

Mohammad Hadi Mansouri

Reihaneh Zavar

Pejman Mansouri

Affiliations

Soon will be listed here.

Abstract

Background: Electrocardiographic (ECG) study is a principle for the symptoms contributed to the acute myocardial infarction (AMI)/acute coronary syndrome (ACS). The diagnosis of involved coronary artery based on ECG changes is still a challenge. This study is aimed to evaluate the association of mere changes in I and aVL leads with the involved region found through echocardiography and involved coronary artery through angiography.

Methods: This cross-sectional study was conducted on 100 patients referred with AMI/ACS symptoms that had mere ECG changes in I and aVL leads (ST elevation + Q wave/ST depression + inverted-T). Transthoracic echocardiography (TTE) and coronary angiography (CAG) were performed for the patients. The correlation of ECG with echocardiography and angiography was assessed.

Results: Among the studied population, 39 patients (39%) were women with the mean ± standard deviation (SD) of age of 64.60 ± 9.39 years. There was no significant association between ECG changes in leads I and aVL with neither the stenosis of first diagonal (D1) coronary artery found through angiography (P = 0.580) nor the mid-anterior wall dyskinesia found through echocardiography (P = 0.380). A remarkable association between the echocardiographic findings representing mid-anterior wall ischemic dyskinesia with the stenosis of D1 coronary artery was detected (P < 0.001). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100%, 54.54%, 94.68%, and 100% were respectively found as the diagnostic values of mentioned factors.

Conclusion: Our findings showed significant association between D1 involvement and mid-anterior dyskinesia in echocardiography, while the changes in ECG were associated neither with echocardiographic nor angiographic outcomes.

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