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

IB Menown, J Allen, JMCC Anderson, AAJ Adgey

Research output: Contribution to journalArticle

49 Citations (Scopus)

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.
LanguageEnglish
Pages218-227
JournalEuropean Heart Journal
Volume22
Issue number3
Publication statusPublished - 2001

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Early Diagnosis
Electrocardiography
Myocardial Infarction
Body Surface Potential Mapping
Chest Pain
Lead

Keywords

  • Aged
  • Body Surface Potential Mapping
  • Electrocardiography
  • Humans
  • Logistic Models
  • Middle Aged
  • Myocardial Infarction: diagnosis
  • Sensitivity and Specificity

Cite this

Menown, IB., Allen, J., Anderson, JMCC., & Adgey, AAJ. (2001). ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction. European Heart Journal, 22(3), 218-227.
Menown, IB ; Allen, J ; Anderson, JMCC ; Adgey, AAJ. / ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction. In: European Heart Journal. 2001 ; Vol. 22, No. 3. pp. 218-227.
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Menown, IB, Allen, J, Anderson, JMCC & Adgey, AAJ 2001, 'ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction', European Heart Journal, vol. 22, no. 3, pp. 218-227.

ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction. / Menown, IB; Allen, J; Anderson, JMCC; Adgey, AAJ.

In: European Heart Journal, Vol. 22, No. 3, 2001, p. 218-227.

Research output: Contribution to journalArticle

TY - JOUR

T1 - ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction

AU - Menown, IB

AU - Allen, J

AU - Anderson, JMCC

AU - Adgey, AAJ

N1 - Comment In: Eur Heart J. 2002 Feb;23(3):255[11792141]; LR: 20061115RX: 850816 (on Jul 22, 2011)

PY - 2001

Y1 - 2001

N2 - 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.

AB - 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.

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KW - Logistic Models

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KW - Myocardial Infarction: diagnosis

KW - Sensitivity and Specificity

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