下壁心肌梗死和右心室梗死患者的 ST 段抬高测量值存在差异。

ST elevation measurements differ in patients with inferior myocardial infarction and right ventricular infarction.

机构信息

Department of Emergency Medicine, University of Ulsan, Seoul, South Korea.

出版信息

Am J Emerg Med. 2011 Nov;29(9):1067-73. doi: 10.1016/j.ajem.2010.06.033. Epub 2010 Sep 25.

DOI:10.1016/j.ajem.2010.06.033

PMID:20870367

Abstract

PURPOSE

Few studies specify the methods used to measure ST-segment elevation (STE). We therefore assessed differences in electrocardiography results depending on STE measurement methods for patients with inferior acute myocardial infarction (MI) and right ventricular infarction.

METHODS

This study was a retrospective analysis. The STE group consisted of 88 patients consecutively admitted to the emergency department with inferior ST elevation MI associated with occlusion of right coronary artery or left circumflex coronary artery who underwent primary percutaneous coronary intervention. The control group consisted of 109 patients with non-ST elevation MI who had occlusion of right coronary artery or left circumflex coronary artery and underwent percutaneous coronary intervention. Measurements were performed at the J point and 60 milliseconds later for limb lead and right precordial V(4) lead (V4R). The criterion of at least 1-mm STE in 2 consecutive leads was applied, and the diagnostic accuracy of V4R was calculated.

RESULTS

In the STE group, the measurements 60 milliseconds after the J point were significantly higher than measurements at the J point at the II, III, aVF, and V4R leads. In the control group, only the measurements at lead I differed significantly. There was a 5% difference in diagnostic sensitivity depending on the measuring points in the STE group, a 1% to 3% difference in the control group, and a 10% to 11% difference at the V4R lead.

CONCLUSION

In patients with inferior MI, STE depends on the method of measurement, indicating a need for the standardization of measurements.

摘要

目的

很少有研究具体说明测量 ST 段抬高（STE）的方法。因此，我们评估了用于测量下壁急性心肌梗死（MI）和右心室梗死患者 STE 的方法对心电图结果的差异。

方法

本研究为回顾性分析。STE 组包括 88 例连续就诊于急诊科的下壁 ST 段抬高 MI 患者，这些患者的右冠状动脉或左回旋支冠状动脉闭塞，并接受了直接经皮冠状动脉介入治疗。对照组包括 109 例右冠状动脉或左回旋支冠状动脉闭塞并接受经皮冠状动脉介入治疗的非 ST 段抬高 MI 患者。肢体导联和右胸前 V4 导联（V4R）在 J 点和 60 毫秒后进行测量。应用至少 2 个连续导联出现 1mm STE 的标准，并计算 V4R 的诊断准确性。