Correlation of electrocardiographic pattern and echocardiographic regional wall motion abnormalities

Abstract

In acute anterior wall myocardial infarction (AWMI), there are electrocardiographic patterns that classically give the clinician an insight into which arterial territory of the left ventricle is compromised and the coronary artery disease severity. Objective: To determine the different electrocardiographic patterns of AWMI and their correlation with echocardiographic regional wall motion abnormalities (RWMA) in patients admitted to the cardiology section of the Ciudad Hospitalaria “Dr. Enrique Tejera” between 2017 and 2019. Method: A retrospective, observational, cross-sectional study was done, in which anterior ST-segment elevation myocardial infarction patients were included, who underwent transthoracic echocardiography. AWMI was divided into 5 subtypes, including 2 nontraditional subtypes, AWMI with ST elevation in inferior wall (AE2), and AWMI with reciprocal changes in inferior
wall (AE3). A p <0.05 was considered as statistically significant. Results: From the 91 assessed patients, 48% had extensive AWMI (AE-1), 26% had AWMI with inferior wall reciprocal changes (AE-3); 19% anteroseptal MI (AS); 4% AWMI with inferior ST elevation (AE-2); and only 2% anterolateral MI (AL). Comparing the RWA abnormalities, AE-1 and AE-2 had a greater compromise of the anterior wall than AS MI. Conclusions: Amongst the most prevalent AWMI types, there were AE-1, AE3 and AS (48%, 26%, 19%). AE-1 and AE3 had greater RWMA compromise and degree of injury of the anterior wall, with higher left ventricular dysfunction than AS MI. AE3 subtype had proportionally the greatest compromise of the inferior wall, suggesting multivessel coronary artery disease.