Morimoto S, Hiasa Y, Hamai K, Wada T, Aihara T, Mori H
Department of Cardiology, Komatsushima Red Cross Hospital, Tokushima.
J Cardiol. 1989 Mar;19(1):47-55.
To assess the characteristic electrocardiographic (ECG) ST changes during acute occlusion of the left circumflex artery (LCX), we observed ECG changes during percutaneous transluminal coronary angioplasty (PTCA) of the LCX and compared the results with those obtained during right coronary angioplasty. Results were as follows: 1. In the 30 patients who had LCX angioplasty (group LCX), ST-segment elevation occurred most frequently in lead V6 (67.7%) and in lead III (46.7%), but rarely in leads and aVL. ST depression occurred most frequently in lead V3 (80.0%) and in lead V2 (73.3%), but rarely in other leads except for leads I and aVL (23.3%, 33.3%). 2. Four types of ST change in lead combinations were observed. These included: (1) ST elevation in the inferior leads (II, III and aVF), (2) ST elevation in the lateral leads (V5 and V6), (3) ST depression in the anterior leads (V2-V4) and (4) ST depression in the high lateral leads (I and aVL). In group LCX, nine cases (30.0%) manifested all four changes, and six cases (20.0%) revealed only ST depression in the anterior leads without ST changes in other leads. 3. ST depression in the anterior leads and ST elevation in the inferior and lateral leads were observed in nearly equal frequency in patients who received PTCA at the proximal site (Seg. 11) and at the distal site (Seg. 13) in the group LCX. However, ST depression in the high-lateral leads was more frequently observed in the distal than in the proximal cases (66.7% vs 33.3%).(ABSTRACT TRUNCATED AT 400 WORDS)
为评估左旋支动脉(LCX)急性闭塞时特征性心电图(ECG)ST段改变,我们观察了LCX经皮腔内冠状动脉成形术(PTCA)期间的ECG变化,并将结果与右冠状动脉成形术期间获得的结果进行比较。结果如下:1. 在接受LCX血管成形术的30例患者(LCX组)中,ST段抬高最常出现在V6导联(67.7%)和III导联(46.7%),但很少出现在导联和aVL导联。ST段压低最常出现在V3导联(80.0%)和V2导联(73.3%),但除I导联和aVL导联外,其他导联很少出现(23.3%,33.3%)。2. 观察到四种导联组合的ST段改变类型。这些包括:(1)下壁导联(II III和aVF)ST段抬高,(2)侧壁导联(V5和V6)ST段抬高,(3)前壁导联(V2-V4)ST段压低,以及(4)高侧壁导联(I和aVL)ST段压低。在LCX组中,9例(30.0%)表现出所有四种改变,6例(20.0%)仅表现为前壁导联ST段压低,其他导联无ST段改变。3. 在LCX组中,近端部位(节段11)和远端部位(节段13)接受PTCA的患者中,前壁导联ST段压低和下壁及侧壁导联ST段抬高的出现频率几乎相等。然而,高侧壁导联ST段压低在远端病例中比近端病例更常见(66.7%对33.3%)。(摘要截断于400字)