入院心电图对急性前壁和前下壁心肌梗死多支血管病变的预测价值。

Predictive value of admission electrocardiogram for multivessel disease in acute anterior and anterior-inferior myocardial infarction.

作者信息

Kürüm Turhan, Oztekin Erkan, Ozçelik Fatih, Eker Hüseyin, Türe Mevlüt, Ozbay Gültaç

机构信息

Department of Cardiology and Biostatistics, School of Medicine, Trakya University, 22030 Edirne, Turkey.

出版信息

Ann Noninvasive Electrocardiol. 2002 Oct;7(4):369-73. doi: 10.1111/j.1542-474x.2002.tb00187.x.

DOI:10.1111/j.1542-474x.2002.tb00187.x

PMID:12431316

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7027603/

Abstract

BACKGROUND

Our aim was to investigate the correlation between admission ECG and coronary angiography findings in terms of predicting the culprit vessel responsible for the infarct or multivessel disease in acute anterior or anterior-inferior myocardial infarction (AMI).

METHODS

We investigated 101 patients with a diagnosis of anterior AMI with or without ST-segment elevation or ST-segment depression in at least two leads in DII, III, aVF. The patients were classified as those with vessel involvement in the left anterior descending (LAD) coronary artery and patients with multivessel disease. Vessel involvement in LAD + circumflex artery (Cx) or LAD + right coronary artery (RCA) or LAD + Cx + RCA were considered as multivessel disease. Thus, (a) anterior AMI patients with reciprocal changes in inferior leads, (b) anterior AMI patients with inferior elevations, (c) all anterior AMI patients according to the ST-segment changes in the inferior region were analyzed according to the presence of LAD or multivessel involvement.

RESULTS

Presence of ST-segment depression in aVL and V6 was significantly correlated with the presence of multivessel disease in anterior AMI patients with reciprocal changes in the inferior leads (P = 0.005 and P = 0.003, respectively). No statistically significant difference between the leads were detected in terms of ST-segment elevation in predicting vessel involvement in the two groups of anterior AMI patients with inferior elevations. When all the patients with anterior AMI were analyzed, the presence of ST-segment depression in leads aVL, V4, V5 and V6 were significantly associated with the presence of multivessel disease (P = 0.035, P = 0.010, P = 0.011, P = 0.001, respectively).

CONCLUSIONS

The presence of ST-segment depression in anterolateral leads in the admission ECG of anterior AMI patients with reciprocal changes in inferior leads was associated with multivessel disease.

摘要

背景

我们的目的是研究入院时心电图（ECG）与冠状动脉造影结果之间的相关性，以预测急性前壁或前下壁心肌梗死（AMI）中导致梗死的罪犯血管或多支血管病变。

方法

我们调查了101例诊断为前壁AMI的患者，这些患者在DII、III、aVF导联中至少有两个导联出现ST段抬高或压低。患者被分为左前降支（LAD）冠状动脉血管受累患者和多支血管病变患者。LAD + 回旋支动脉（Cx）或LAD + 右冠状动脉（RCA）或LAD + Cx + RCA血管受累被视为多支血管病变。因此，（a）下壁导联有对应性改变的前壁AMI患者，（b）下壁导联有ST段抬高的前壁AMI患者，（c）根据下壁区域ST段改变的所有前壁AMI患者，根据LAD或多支血管受累情况进行分析。

结果

在有下壁对应性改变的前壁AMI患者中，aVL和V6导联出现ST段压低与多支血管病变显著相关（分别为P = 0.005和P = 0.003）。在两组有下壁ST段抬高的前壁AMI患者中，预测血管受累方面，各导联ST段抬高情况无统计学显著差异。当分析所有前壁AMI患者时，aVL、V4、V5和V6导联出现ST段压低与多支血管病变显著相关（分别为P = 0.035、P = 0.010、P = 0.011、P = 0.001）。