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Continuously updated 12-lead ST-segment recovery analysis for myocardial infarct artery patency assessment and its correlation with multiple simultaneous early angiographic observations.

Publication ,  Journal Article
Krucoff, MW; Croll, MA; Pope, JE; Pieper, KS; Kanani, PM; Granger, CB; Veldkamp, RF; Wagner, BL; Sawchak, ST; Califf, RM
Published in: Am J Cardiol
January 15, 1993

Early angiography may not adequately subgroup patients with myocardial infarction if cyclic changes in coronary flow occur frequently. From a pilot experience using a new 12-lead ST-segment monitor, a continuously updated, self-referenced ST-recovery analysis method was developed to quantify both instantaneous recovery, as a noninvasive marker of patency, and cumulative ST recovery over time, as a marker of the speed, stability and duration of reperfusion. In 22 patients with acute infarction in whom 44 observations of unique angiographic patency were noted within 6 hours of presentation, serial patency assessments simultaneous with all angiographic observations predicted coronary occlusion with 90% sensitivity and 92% specificity. Of the 22 patients, 11 (50%) had multiple ST trend transitions suggesting cyclic changes in coronary flow before catheterization. Speed, stability and duration of ST-segment recovery were defined by the time to first 50% ST recovery, total number of ST-trend transitions and patent physiology index (percentage of monitoring period showing ST recovery), respectively. Subgrouped angiographically, the median (interquartile range) for cumulative ST parameters with patent (n = 8) versus occluded (n = 14) arteries were, respectively--time to 50% recovery, 1.57 (1.16, 1.70) versus 0.17 (-0.47, 0.32) hours; number of reelevation/recovery events, 1.5 (1, 3) versus 3 (1, 3); and patent physiology index, 52 (47, 59) versus 50 (5, 73). Thus, continuous ST-segment recovery analysis appears to predict simultaneous angiographic patency over serial assessments, whereas cumulative parameters appear to contain independent information, probably because of patency changes before or after angiography.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

January 15, 1993

Volume

71

Issue

2

Start / End Page

145 / 151

Location

United States

Related Subject Headings

  • Vascular Patency
  • Time Factors
  • Signal Processing, Computer-Assisted
  • Sensitivity and Specificity
  • Pilot Projects
  • Myocardial Infarction
  • Monitoring, Physiologic
  • Humans
  • Electrocardiography
  • Coronary Vessels
 

Citation

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Krucoff, M. W., Croll, M. A., Pope, J. E., Pieper, K. S., Kanani, P. M., Granger, C. B., … Califf, R. M. (1993). Continuously updated 12-lead ST-segment recovery analysis for myocardial infarct artery patency assessment and its correlation with multiple simultaneous early angiographic observations. Am J Cardiol, 71(2), 145–151. https://doi.org/10.1016/0002-9149(93)90729-v
Krucoff, M. W., M. A. Croll, J. E. Pope, K. S. Pieper, P. M. Kanani, C. B. Granger, R. F. Veldkamp, B. L. Wagner, S. T. Sawchak, and R. M. Califf. “Continuously updated 12-lead ST-segment recovery analysis for myocardial infarct artery patency assessment and its correlation with multiple simultaneous early angiographic observations.Am J Cardiol 71, no. 2 (January 15, 1993): 145–51. https://doi.org/10.1016/0002-9149(93)90729-v.
Krucoff, M. W., et al. “Continuously updated 12-lead ST-segment recovery analysis for myocardial infarct artery patency assessment and its correlation with multiple simultaneous early angiographic observations.Am J Cardiol, vol. 71, no. 2, Jan. 1993, pp. 145–51. Pubmed, doi:10.1016/0002-9149(93)90729-v.
Krucoff MW, Croll MA, Pope JE, Pieper KS, Kanani PM, Granger CB, Veldkamp RF, Wagner BL, Sawchak ST, Califf RM. Continuously updated 12-lead ST-segment recovery analysis for myocardial infarct artery patency assessment and its correlation with multiple simultaneous early angiographic observations. Am J Cardiol. 1993 Jan 15;71(2):145–151.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

January 15, 1993

Volume

71

Issue

2

Start / End Page

145 / 151

Location

United States

Related Subject Headings

  • Vascular Patency
  • Time Factors
  • Signal Processing, Computer-Assisted
  • Sensitivity and Specificity
  • Pilot Projects
  • Myocardial Infarction
  • Monitoring, Physiologic
  • Humans
  • Electrocardiography
  • Coronary Vessels