N-Terminal Pro-Brain Natriuretic Peptide in combination with the 80-lead Body Surface Map Improves Detection of Acute Inferior Myocardial Infarction with Right Ventricular Involvement

Abstract Right ventricular myocardial infarction with an acute inferior infarction remains a diagnostic challenge and is associated with increased rates of morbidity and mortality necessitating rapid myocardial reperfusion for their reduction. In this study, we have shown that in patients with acute inferior-territory myocardial infarction, the early combination of Body Surface Potential Mapping and serum N-terminal pro-Brain Natriuretic peptide identifies those with right ventricular involvement -a group where early reperfusion is paramount. Introduction Acute myocardial infarction (AMI) involving only the right ventricle (RV) is a rare event [1], however its involvement in the context of inferior AMI is much more common Regarding clinical diagnosis, the triad of hypotension, clear lung fields and elevated jugular venous pressure in a patient with inferior AMI is virtually pathognomonic of RVMI We hypothesize that the combination of BSPM and plasma NT-proBNP will improve the diagnosis of RVMI complicating inferior-wall AMI. Methods Study population Between January 2003 and January 2006 we retrospectively studied all patients admitted to our coronary care unit using either the emergency department or mobile coronary care unit (MCCU). Patients were excluded from analysis if they were unable to provide informed consent or had any of the following: conditions precluding STE on ECG, i.e. left bundle branch block defined as QRS duration ≥ 120ms, QS or rS wave in lead V 1 and slurred R waves in leads I and V 5 or V 6 [11], right bundle branch block defined as QRS duration ≥ 120ms, rSR' complex in leads V 1 and V 2 and S waves in leads I and V 5 or V 6 [11], left ventricular hypertrophy defined as a sum of the R wave in leads V 5 or V 6 and S wave in V 1 ≥ 3.8mV [12], digitalis therapy or ventricular pacing (247 patients); had received fibrinolytic therapy, nitrates or glycoprotein IIb/IIIa inhibitors prior to initial ECG or BSPM; prior history of coronary artery bypass grafting (CABG) surgery; BSPM recorded >15mins after initial 12-lead ECG; left ventricular ejection fraction <55%; severe valvular disease; or renal impairment (eGFR<30ml/hr). Those who fulfilled the following criteria were studied

Observation of the J/ψψ →\to μ+μ−μ+μ−μ^+μ^-μ^+μ^- decay in proton-proton collisions at s\sqrt{s} = 13 TeV

A preprint version of the article is available at arXiv:2403.11352v2 [hep-ex], https://arxiv.org/abs/2403.11352. Comments: Replaced with the published version. Added the journal reference and the DOI. All the figures and tables can be found at https://cms-results.web.cern.ch/cms-results/public-results/publications/BPH-22-006 (CMS Public Pages). Report number: CMS-BPH-22-006, CERN-EP-2024-058.The /→+⁢−⁢+⁢− decay has been observed with a statistical significance in excess of five standard deviations. The analysis is based on an event sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the CMS experiment in 2018 and corresponding to an integrated luminosity of 33.6  fb−1. Normalizing to the /→+⁢− decay mode leads to a branching fraction of [10.1+3.3 −2.7⁢(stat)±0.4⁢(syst)]×10−7, a value that is consistent with the standard model prediction.SCOAP3