Sun Tong-Wen, Wang Le-Xin, Zhang Yan-Zhou
Department of Emergency Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
Intern Med. 2007;46(12):795-9. doi: 10.2169/internalmedicine.46.6411. Epub 2007 Jun 15.
To investigate whether the ST changes in the aVR lead on 12-lead ECG can be used to identify infarct-related artery (IRA) in patients with acute inferior myocardial infarction.
The ECG features were studied in 90 patients with acute inferior myocardial infarction where IRA was confirmed by coronary angiography.
Right coronary artery (RCA) and the left circumflex coronary artery (LCX) were identified as IRA in 70 and 20 patients, respectively. ST depression in aVR > or = 0.1 mV was found in 14 (70%) patients who had LCX as the IRA, and in 4 (5.7%, p<0.001) patients with RCA as IRA. Using ST segment depression > or = 0.1 mV in aVR as a criterion, the sensitivity and specificity in differentiating LCX as IRA was 70.0% and 94.3%, respectively.
ST depression in aVR is common in patients with LCX-related acute inferior myocardial infarction. The ST changes in this lead are associated with an excellent specificity and a good sensitivity in differentiating LCX from RCA as the IRA.
探讨12导联心电图aVR导联ST段改变能否用于识别急性下壁心肌梗死患者的梗死相关动脉（IRA）。
对90例经冠状动脉造影证实IRA的急性下壁心肌梗死患者的心电图特征进行研究。
分别有70例和20例患者的IRA为右冠状动脉（RCA）和左旋支冠状动脉（LCX）。以LCX为IRA的患者中有14例（70%）aVR导联ST段压低≥0.1mV，以RCA为IRA的患者中有4例（5.7%，p<0.001）aVR导联ST段压低≥0.1mV。以aVR导联ST段压低≥0.1mV为标准，鉴别LCX为IRA的敏感性和特异性分别为70.0%和94.3%。
aVR导联ST段压低在LCX相关急性下壁心肌梗死患者中常见。该导联的ST段改变在鉴别LCX与RCA作为IRA方面具有极佳的特异性和良好的敏感性。
