{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:50:09Z","timestamp":1789469409195,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2007,1,29]],"date-time":"2007-01-29T00:00:00Z","timestamp":1170028800000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2007,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lead V<jats:sub>4R<\/jats:sub> faces the right ventricular free wall; it also reflects ischemia in the posterolateral wall lying opposite and manifests as ST\u2010segment depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>The aim of this study was to evaluate the usefulness of V<jats:sub>4R<\/jats:sub> ST\u2010segment depression in distinguishing proximal from distal left circumflex artery occlusion in acute inferoposterior wall myocardial infarction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 239 patients who had first acute inferoposterior myocardial infarction, were admitted within 6 h from onset of symptom, and had coronary angiography performed within 4 weeks. Patients who had bundle\u2010branch block or concomitant significant stenoses in the proximal and distal segments of the same vessel or of both vessels were excluded. The electrocardiographic and angiographic findings were reviewed by two independent groups of investigators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>V<jats:sub>4R<\/jats:sub> ST\u2010segment depression \u22651.0 mm was found in 8 of 46 patients (17.4%) with left circumflex artery occlusion but none (0%) with right coronary artery occlusion. Among the group with left circumflex artery occlusion, the mean magnitude of V<jats:sub>4R<\/jats:sub> ST\u2010segment depression was greater in proximal than distal occlusion (0.82 \u00b1 0.65 vs. 0.03 \u00b1 0.12 mm, p &lt; 0.0001). V<jats:sub>4R<\/jats:sub>ST\u2010segment depression \u22651.0 mm was found in 8 of 14 patients (57.1%) with proximal occlusion but none (0%) in 32 patients with distal occlusion. The sensitivity and specificity to predict proximal occlusion were 57.1 and 100%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>V<jats:sub>4R<\/jats:sub> ST\u2010segment depression \u22651.0 mm was not useful for differentiating left circumflex and right coronary artery occlusion because of its low sensitivity. It is a fairly sensitive and very specific sign of proximal left circumflex artery occlusion. Copyright \u00a9 2007 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.4","type":"journal-article","created":{"date-parts":[[2007,2,2]],"date-time":"2007-02-02T18:51:13Z","timestamp":1170442273000},"page":"36-41","source":"Crossref","is-referenced-by-count":6,"title":["Value of ST\u2010segment depression in lead V<sub>4R<\/sub> in predicting proximal against distal left circumflex artery occlusion in acute inferoposterior myocardial infarction"],"prefix":"10.1002","volume":"30","author":[{"given":"Man\u2010Hong","family":"Jim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee\u2010Hwa","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010Wah","family":"Siu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Miu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Wing\u2010Sze","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Wai\u2010Luen","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chu\u2010Pak","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,1,29]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.19.2239"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960231109"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)00929-2"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00678-4"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00634-1"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.05.053"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.07.086"},{"issue":"6","key":"e_1_2_1_9_2","first-page":"271","article-title":"Electrocardiographic discrimination of infarct\u2010related artery between left circumflex and right coronary artery: Comparison of ST elevation between leads II and III","volume":"41","author":"Misumi I","year":"2003","journal-title":"J Cardiol"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(84)90575-7"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2004.94585.x"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00126-6"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199304083281401"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.2.436"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960240310"},{"issue":"2","key":"e_1_2_1_16_2","first-page":"413","article-title":"Precordial ST\u2010segment depression in acute inferior myocardial infarction: The importance of posterolateral wall infarction","volume":"19","author":"Nishian K","year":"1989","journal-title":"J Cardiol"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.111.4.1039"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.4","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.4","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T17:38:33Z","timestamp":1699983513000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2007,1]]}},"alternative-id":["10.1002\/clc.4"],"URL":"https:\/\/doi.org\/10.1002\/clc.4","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1]]}}}