• Yumiko Kanei, Jyoti Sharma, Ravi Diwan, Ron Sklash, Lori L Vales, John T Fox, and Paul Schweitzer.
• Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York, NY 10003, USA. yumikanei@hotmail.com
• J Electrocardiol. 2010 Mar 1;43(2):132-5.

BackgroundST-segment depression in lead aVR in acute inferior wall ST-segment elevation myocardial infarction (STEMI) has recently been suggested as a predictor of left circumflex (LCx) artery involvement. The purpose of this study is to evaluate the clinical significance of aVR depression during inferior wall STEMI.MethodsThis study included 106 consecutive patients who presented with inferior wall STEMI and underwent urgent coronary angiogram. Clinical and angiographic findings were compared between patients with and without aVR depression > or = 0.1 mV.ResultsThe sensitivity and specificity of aVR depression as a predictor of LCx infarction were 53% and 86%, respectively. In patients with right coronary artery infarction, aVR depression was associated with increased cardiac enzymes and the involvement of a large posterolateral branch, which may explain the larger infarction.ConclusionsST-segment depression in lead aVR in inferior wall STEMI predicts LCx infarction or larger RCA infarction involving a large posterolateral branch.2010 Elsevier Inc. All rights reserved.

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