Kehl K
Klinikum Berlin-Buch.
Z Gesamte Inn Med. 1991 Mar;46(3):68-71.
In this study 57 test persons 15 healthy ones, 42 patients with myocardial infarction with disturbances of the wall excursion) were examined by means of the mapping ECG, the classical ECG and the echocardiography. Considering the healthy test persons the normal values of the Q-deflections were established for every individual lead of the mapping ECG and of this the borderline values for the necrosis-Q (Q less than Q(m-1 s] were derived. The topographic coordination was performed with the help of a computer-aided picture of the thoracic surface. The determination of the localization of an echocardiographically proved disturbance of the wall excursion by means of the mapping ECG on the basis of the borderline values stated for the Q-deflections was carried out with an efficiency of 0.810 and by means of the classical ECG with an efficiency of 0.690. The information of the Q-deflections in the mapping ECG about the presence of an echocardiographically provable disturbance of the wall excursion is possible with an efficiency of 0.833. For the diagnosis of an infarction all infarction-typical parameters should always be used simultaneously. The clinical significance of the diagnostics of myocardial infarction by means of the mapping ECG lies in the exact localisation, the gradual valuation of the size of the infarction, in the recognition of changed potential distribution pattern as sign of the activity of a coronary heart disease with the complication of a myocardial infarction and the establishment of smaller as well as nontransmural myocardial infarctions with non-invasive methods.
在本研究中,对57名测试对象(15名健康者,42名伴有室壁运动障碍的心肌梗死患者)进行了标测心电图、经典心电图及超声心动图检查。以健康测试对象为参照,确定了标测心电图各导联Q波偏移的正常值,并由此得出坏死Q波(Q小于Q(m-1 s])的临界值。借助胸部表面的计算机辅助图像进行了地形学匹配。基于所规定的Q波偏移临界值,通过标测心电图确定超声心动图证实的室壁运动障碍的定位,其效率为0.810,而通过经典心电图确定的效率为0.690。标测心电图中Q波偏移关于超声心动图可证实的室壁运动障碍存在情况的信息获取效率为0.833。对于梗死的诊断,所有典型梗死参数应始终同时使用。通过标测心电图诊断心肌梗死的临床意义在于精确的定位、梗死面积的逐步评估、识别作为冠心病伴心肌梗死并发症活动迹象的电位分布模式变化以及用非侵入性方法确定较小的及非透壁性心肌梗死。