A Prominent R Wave in V-1 but not in V-2 Is a Specific Sign of a Large Lateral Transmural Infarction

作者：Rovai Daniele^*; Di Bella Gianluca; Rossi Giuseppe; Pingitore Alessandro; L' Abbate Antonio

来源：Revista Espanola de Cardiologia, 2012, 65(12): 1101-1105.

DOI：10.1016/j.rec.2012.05.015

• Electrocardiography
• Myocardial infarction
• Magnetic resonance imaging
• Imaging
• Coronary disease

Introduction and objectives: In the absence of right ventricular hypertrophy or bundle-branch block, a prominent R wave in V-1 or V-2 is considered to reflect a lateral myocardial infarction. We investigated the differences in infarct location, size and transmural extent between patients with prominent R wave in V-1 and those with prominent R wave in V-2. %26lt;br%26gt;Methods: We studied 50 patients with a previous first infarction involving left ventricular inferior and/or lateral wall at contrast-enhanced magnetic resonance. %26lt;br%26gt;Results: A prominent R wave in V-1 was present in 8 patients (16%), in V-2 in 23 (46%). At magnetic resonance, the infarction involved the inferior wall in 11 patients (22%), the lateral wall in 6 (12%), and both walls in 33 patients (66%). The sensitivity of a prominent R wave in V-1 in detecting a lateral infarction was low (17.9%), while the specificity was high (90.9%). The sensitivity and specificity of a prominent R wave in V-2 were 46.2% and 54.5%, respectively. In patients with a prominent R wave in V-1, infarct size and lateral and transmural extent were greater than in patients without this pattern (P%26lt;.005, %26lt;.001, and %26lt;.05, respectively); conversely, infarct size and transmural extent in the inferior wall and in its basal-posterior segment were not significantly different. In patients with a prominent R wave in V-2, infarct size, lateral and transmural extent were not different from patients without this pattern. %26lt;br%26gt;Conclusions: Only a prominent R wave in V-1 is a specific sign of large and transmural lateral infarction.

• 出版日期2012-12