The myocardial infarction size measuring using modern methods

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Abstract

An accurate quantitative assessment of myocardium necrosis area and the viable zone (stunned and hibernating) in patients with myocardial infarction is crucial for the preoperative patient selection and predicting the cardiac surgery effectiveness. Currently, researchers and clinicians are most interested in the problem of determining the viable myocardium zone. However, only the necrosis zone area directly correlates with the patient’s prognosis and determines the heart pathological remodeling processes. In the distant period, the data obtained can be used to predict the post-infarction period course or for analysis the relationship of the necrosis zone with arrhythmogenesis, and a number of other indicators. Thus, the necrosis zone and the viable myocardium zone are two parameters that need to be monitored in dynamics in all patients after myocardial infarction. The most accurate and reproducible method for determining the necrosis area is contrast magnetic resonance imaging of the heart, however, this technique is still inaccessible in most hospitals. In this regard, it remains relevant to estimate the necrotic myocardium area by ubiquitous non-invasive methods such as electrocardiography and echocardiography.

About the authors

E. A. Shigotarova

Burdenko Penza Oblast Clinical Hospital

Email: v.oleynikof@gmail.com
ORCID iD: 0000-0003-4452-2049

к.м.н., врач-кардиолог кардиологического отд-ния с палатой реанимации и интенсивной терапии

Russian Federation, Penza

V. A. Galimskaja

Penza State University

Email: v.oleynikof@gmail.com
ORCID iD: 0000-0001-7545-8196

к.м.н., доц. каф. терапии

Russian Federation, Penza

A. V. Golubeva

Penza State University

Email: v.oleynikof@gmail.com
ORCID iD: 0000-0001-6640-6108

ассистент каф. терапии

Russian Federation, Penza

V. E. Oleynikov

Penza State University

Author for correspondence.
Email: v.oleynikof@gmail.com
ORCID iD: 0000-0002-7463-9259

д.м.н., проф., зав. каф. терапии

Russian Federation, Penza

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2. Stage of ischemia. In the leads with the configuration Rs (leads V1 – V3): stage I - high, symmetrical T waves without elevation of the ST segment; stage II - ST elevation without changing the terminal part of the QRS complex; Stage III - ST elevation with a change in the terminal part of the QRS complex [there is no S wave in leads V1 – V3] (arrow). In leads with qR configuration: stage I - high, symmetrical T waves without ST segment elevation; stage II - ST elevation with a ratio of T.J / R <0.5; stage III - ST elevation with a ratio of T.J / R> 0.5 (arrow) [19].

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