ST段抬高型前壁急性心肌梗死时aVR导联ST段水平的决定因素
Determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction with ST-segment elevation.
作者信息
Kotoku Munenori, Tamura Akira, Abe Yusei, Kadota Junichi
机构信息
Internal Medicine 2, Oita University, Yufu, Japan.
出版信息
J Electrocardiol. 2009 Mar-Apr;42(2):112-7. doi: 10.1016/j.jelectrocard.2008.10.006. Epub 2008 Dec 6.
BACKGROUND
This study aimed to clarify the determinants of ST-segment level in lead aVR in anterior wall acute myocardial infarction (AAMI).
METHODS
We analyzed ST-segment levels in all 12 leads on admission and emergency coronary angiographic findings in 261 patients with a first AAMI with ST-segment elevation. The length of the left anterior descending coronary artery (LAD) was classified as follows: short = not reaching the apex; medium = perfusing less than 25% of the inferior wall; long = perfusing 25% or more of the inferior wall.
RESULTS
The ST-segment level in lead aVR correlated significantly with the ST-segment levels in leads I, II, III, aVF, V(1), and V(3-6), especially with those in leads II and V(6) (r = -0.63, P < .001; r = -0.61, P < .001; respectively). Patients with a proximal LAD occlusion had a greater ST-segment level in lead aVR than those with a distal LAD occlusion (P < .001). Patients with a long LAD had a lower ST-segment level than those with a short or medium LAD (P < .05).
CONCLUSIONS
The ST-segment levels, especially in leads II and V(6), the site of the LAD occlusion, and the length of the LAD affect the ST-segment level in lead aVR in ST-segment elevation AAMI.
背景
本研究旨在阐明前壁急性心肌梗死（AAMI）患者aVR导联ST段水平的决定因素。
方法
我们分析了261例首次发生ST段抬高型AAMI患者入院时12导联的ST段水平及急诊冠状动脉造影结果。左前降支冠状动脉（LAD）的长度分类如下：短 = 未达心尖；中 = 供血至下壁不足25%；长 = 供血至下壁25%或更多。
结果
aVR导联的ST段水平与I、II、III、aVF、V(1)和V(3 - 6)导联的ST段水平显著相关，尤其是与II导联和V(6)导联的ST段水平相关（分别为r = -0.63，P <.001；r = -0.61，P <.001）。LAD近端闭塞的患者aVR导联的ST段水平高于LAD远端闭塞的患者（P <.001）。LAD长的患者ST段水平低于LAD短或中的患者（P <.05）。
结论
ST段水平，尤其是II导联和V(6)导联的ST段水平、LAD闭塞部位以及LAD长度，影响ST段抬高型AAMI患者aVR导联的ST段水平。
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