Shen W F, Xing H L, Wang M H, Gong L S, Lesbre J P
Department of Cardiology, Ruijin Hospital, Shanghai Second Medical University.
Chin Med J (Engl). 1991 May;104(5):369-75.
The electrocardiographic (ECG) patterns related to clinical spectrum and angiographic features were assessed in 41 patients with first myocardial infarction due to isolated left circumflex coronary artery (LCX) occlusion, and compared to those in 45 patients with right coronary artery (RCA)-related infarction. The occurrence of inferior Q waves was similar in patients with LCX and RCA occlusion, but lateral Q waves and an abnormal R wave in lead V1 were more frequently seen in patients with LCX-related infarction (46% vs 7% and 51% vs 4%, respectively). Compared with patients with LCX-related infarction without an abnormal R wave in lead V1 and those with RCA occlusion, patients with LCX-related infarction and an abnormal R wave in lead V1 associated with inferior and/or lateral Q waves had larger left ventricular end-diastolic and end-systolic volumes, lower ejection fraction, higher incidence of total occlusion of a dominant LCX without collaterals, and more cardiac events during follow-up. The study suggests that the presence of lateral Q waves and an abnormal R wave in lead V1 after myocardial infarction may be a useful marker of LCX occlusion, and that patients with LCX-related infarction may have different status of left ventricular function depending on the size of circulation and the status of residual flow to the infarct region during LCX occlusion.
对41例因孤立性左旋冠状动脉（LCX）闭塞导致首次心肌梗死的患者的心电图（ECG）模式与临床谱及血管造影特征进行了评估，并与45例右冠状动脉（RCA）相关梗死患者的情况进行了比较。LCX闭塞和RCA闭塞患者下壁Q波的发生率相似，但LCX相关梗死患者更常出现侧壁Q波和V1导联R波异常（分别为46%对7%和51%对4%）。与V1导联无R波异常的LCX相关梗死患者及RCA闭塞患者相比，V1导联R波异常伴下壁和/或侧壁Q波的LCX相关梗死患者左心室舒张末期和收缩末期容积更大，射血分数更低，优势LCX无侧支循环完全闭塞的发生率更高，随访期间心脏事件更多。该研究表明，心肌梗死后侧壁Q波和V1导联R波异常可能是LCX闭塞的有用标志物，且LCX相关梗死患者的左心室功能状态可能因LCX闭塞时梗死区域的循环大小和残余血流状况而异。
