冠心病患者经皮冠状动脉介入治疗前后的缺血性J波

[Ischemic J wave before and post percutaneous coronary intervention in patients with coronary artery disease].

作者信息

Guo Wu-yi, Li Bao, Zhang Xiao-min

机构信息

Department of Electrocardiogram, Shanxi Cardiovascular Hospital, Taiyuan 030024, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2011 Dec;39(12):1083-7.

PMID:22336499

Abstract

OBJECTIVE

To explore the change of electrocardiographic ischemic J wave in patients with coronary heart disease (CHD) underwent percutaneous coronary intervention (PCI).

METHODS

CHD patients (CHD, n = 162) underwent PCI in the hospital were divided into unstable angina pectoris (angina pectoris group, n = 108) and acute myocardial infarction group (AMI group, n = 54), 12-lead electrocardiogram was recorded within 24 hours before and after PCI. Patients were further grouped into left anterior descending artery group and right or circumflex coronary artery stenosis group. The incidence, amplitude and time course of J waves were measured and analyzed.

RESULTS

(1) The highest incidence of J wave appeared in II, III, aVF leads pre- and post-PCI in CHD groups (33.95%, 22.84%, 26.54% and 30.86%, 19.75%, 23.46%). Higher incidence of J wave in AMI group was evidenced in V(5), II, aVF, III, V(3) leads before PCI (33.33%, 27.78%, 16.67%, 12.96%, 11.11%) and in V(5), II, aVF, aVL, III leads after PCI (22.22%, 22.22%, 14.81%, 12.96%, 9.26%). (2) Before PCI, higher incidence of J wave was found in V(5), V(6) leads (25.78%) in left anterior descending artery group and in II, III, aVF leads (35.37%) in right or circumflex coronary artery stenosis group. After PCI, the higher incidence of J wave in left anterior descending artery group and right or circumflex coronary artery stenosis group was evidenced in II, III, aVF leads (21.09% and 35.37%, respectively). (3) The ischemic J wave' amplitude and time course in II, III, aVF, V(3), V(4) leads were significantly reduced post PCI in CHD patients.

CONCLUSIONS

Higher incidence of J wave was found in II, III, aVF in CHD patients. PCI is associated with reduced amplitude and time course of J wave suggesting PCI could improve ischemic J waves in CHD patients.

摘要

目的

探讨冠心病（CHD）患者行经皮冠状动脉介入治疗（PCI）后心电图缺血性J波的变化。

方法

将在我院接受PCI治疗的CHD患者（CHD，n = 162）分为不稳定型心绞痛组（心绞痛组，n = 108）和急性心肌梗死组（AMI组，n = 54），在PCI术前及术后24小时内记录12导联心电图。患者进一步分为左前降支组和右冠状动脉或回旋支狭窄组。测量并分析J波的发生率、振幅及时间进程。

结果

（1）CHD组PCI术前及术后J波发生率最高的导联为Ⅱ、Ⅲ、aVF导联（分别为33.95%、22.84%、26.54%和30.86%、19.75%、23.46%）。AMI组PCI术前V(5)、Ⅱ、aVF、Ⅲ、V(3)导联J波发生率较高（分别为33.33%、27.78%、16.67%、12.96%、11.11%），PCI术后V(5)、Ⅱ、aVF、aVL、Ⅲ导联J波发生率较高（分别为22.22%、22.22%、14.81%、12.96%、9.26%）。（2）PCI术前，左前降支组V(5)、V(6)导联J波发生率较高（25.78%），右冠状动脉或回旋支狭窄组Ⅱ、Ⅲ、aVF导联J波发生率较高（35.37%）。PCI术后，左前降支组和右冠状动脉或回旋支狭窄组Ⅱ、Ⅲ、aVF导联J波发生率较高（分别为21.09%和35.37%）。（3）CHD患者PCI术后Ⅱ、Ⅲ、aVF、V(3)、V(4)导联缺血性J波的振幅及时间进程显著降低。