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ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction

Biomedical Sciences Research Institute Computer Science Research Institute Environmental Sciences Research Institute Nanotechnology & Advanced Materials Research Institute

Menown, IB, Allen, J, Anderson, JMCC and Adgey, AAJ (2001) ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction. European Heart Journal, 22 (3). pp. 218-227. [Journal article]

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Abstract

To compare the diagnostic ability of the 12-lead ECG with body surface mapping for early detection of acute myocardial infarction in patients presenting with ST depression only on the 12-lead ECG.Fifty-four consecutive patients with chest pain <24 h and ST depression were recruited. A 12-lead ECG and 80-lead body surface map were recorded at presentation from which univariate and multivariate prediction models of acute myocardial infarction were developed. Patients were randomly divided into a training-set and a validation-set. Acute myocardial infarction occurred in 16/30 training-set and 8/24 validation-set patients. Univariate prediction of acute myocardial infarction by the 12-lead ECG, based on the depth or numbers of leads with ST depression, was not improved by assessment of ST elevation outside the conventional 12 leads using body surface mapping. The optimum multivariate 12-lead ECG model developed in training-set patients (six ST depression variables) had poor sensitivity (38%) although good specificity (81%) for acute myocardial infarction when tested prospectively in validation-set patients. In contrast, the optimum body surface mapping model developed in training-set patients (three isointegral or isopotential variables) achieved high sensitivity (88%) whilst maintaining good specificity (75%) for acute myocardial infarction when tested prospectively in validation-set patients.Body surface mapping, when compared with the 12-lead ECG, may improve the early diagnosis of acute myocardial infarction in patients presenting with chest pain and ST depression only on the 12-lead ECG.Copyright 2001 The European Society of Cardiology.

Item Type:Journal article
Keywords:Aged; Body Surface Potential Mapping; Electrocardiography; Humans; Logistic Models; Middle Aged; Myocardial Infarction: diagnosis; Sensitivity and Specificity
Faculties and Schools:Faculty of Computing & Engineering
Faculty of Computing & Engineering > School of Engineering
ID Code:19136
Deposited By:Mrs Ann Blair
Deposited On:29 Jul 2011 13:30
Last Modified:29 Jul 2011 13:30

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