Sternberg L, Wisneski J A, Ullyot D J, Gertz E W
Circulation. 1975 Dec;52(6):1037-44. doi: 10.1161/01.cir.52.6.1037.
From June 1969 to December 1974, 142 patients underwent aortocoronary bypass surgery at the Veterans Administration Hospital, San Francisco. Seventeen patients developed new Q waves; two of four deaths in the hospital occurred among these 17 patients. Preoperative and postoperative catheterization data were available for analysis in 12 of the 15 surviving patients. Longitudinal, transverse, and hemiaxial segmental analysis of preoperative and postoperative single plane, 30 degrees right anterior oblique left ventriculograms revealed deterioration in wall motion in all 12 patients. The deterioration corresponded to the area on the electrocardiogram where the new Q waves appeared. In ten of 12 patients, ejection fraction also deteriorated. Twenty-six of 29 grafts were patent. New Q waves after aortocoronary bypass surgery correlate well with the appearance of localized abnormalities in wall motion. We found no evidence that perioperative appearance of Q waves was not due to new perioperative myocardial infarction.
1969年6月至1974年12月期间，142例患者在旧金山退伍军人管理局医院接受了主动脉冠状动脉搭桥手术。17例患者出现了新的Q波；医院内4例死亡患者中有2例发生在这17例患者中。15例存活患者中有12例可获得术前和术后的导管检查数据用于分析。对术前和术后单平面、右前斜30度左心室造影进行纵向、横向和半轴节段分析，发现所有12例患者的壁运动均恶化。这种恶化与心电图上新Q波出现的区域相对应。12例患者中有10例射血分数也恶化。29条移植血管中有26条通畅。主动脉冠状动脉搭桥手术后新出现的Q波与壁运动局部异常的出现密切相关。我们没有发现证据表明围手术期Q波的出现不是由于围手术期新发生的心肌梗死。
