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[实验性右心室梗死时右胸前导联ST段抬高的意义]

[Significance of right precordial ST elevation in experimental right ventricular infarction].

作者信息

Sanada T, Kaida H, Kubouchi Y, Okamura T

出版信息

Kokyu To Junkan. 1989 Sep;37(9):991-5.

PMID:2595142
Abstract

We produced experimental isolated right ventricular infarction (RVI) with closed chest method, and examined ECG changes of right precordial leads and changes of cardiac output (C. O) in 19 dogs. As a result, ECG showed ST depressions in leads, II, III, aVF and V2-V6 and ST elevations in a VR lead in all 15 cases of the proximal occlusion of right coronary artery (RCA). In 10 of 15 dogs ST elevations in some right precordial leads occurred, and the sensitivity of ST elevation in single right precordial lead was 60% (V5R), 53% (V4R) and 47% (V3R and V1), respectively for the detection of RVI. When left circumflex artery (LCX) was occluded, ST elevation in V4R lead after RCA occlusion was blocked. Therefore, it is thought that the sensitivity of ST elevation in right precordial lead may be lower than expectation in identifying RVI. Concerning anterior chest leads, none of 15 dogs with RVI showed ST elevations in leads V2-V6 in this study. If ST elevations in right precordial leads did not appear, variation of C.O was small and C.O reduced in proportion to the extension of ST elevations in right precordial leads.

摘要

我们采用闭胸法制作实验性孤立性右心室梗死(RVI),并对19只犬右胸前导联的心电图变化及心输出量(C.O)变化进行了检测。结果显示,在所有15例右冠状动脉(RCA)近端闭塞的病例中,心电图在Ⅱ、Ⅲ、aVF及V2-V6导联出现ST段压低,在aVR导联出现ST段抬高。在15只犬中的10只,部分右胸前导联出现ST段抬高,单个右胸前导联ST段抬高对RVI检测的敏感性分别为:V5R导联60%、V4R导联53%、V3R和V1导联47%。当左旋支动脉(LCX)闭塞时,RCA闭塞后V4R导联的ST段抬高被阻断。因此,认为右胸前导联ST段抬高在识别RVI时的敏感性可能低于预期。关于胸前导联,本研究中15只患有RVI的犬在V2-V6导联均未出现ST段抬高。若右胸前导联未出现ST段抬高,心输出量变化较小,且心输出量随右胸前导联ST段抬高范围的扩大而呈比例降低。

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