与血管造影结果相比，后壁心肌梗死的心电图特征。

Electrocardiographic characteristics of posterior myocardial infarction in comparison to angiographic findings.

作者信息

Shemirani Hasan, Nayeri-Torshizi Elham

机构信息

Professor, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Resident, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

ARYA Atheroscler. 2015 Jan;11(1):30-5.

PMID:26089928

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4460350/

Abstract

BACKGROUND

Myocardial infarction (MI) is a cardiac cell death following the imbalance of supply and demand. Electrocardiography (ECG) is a diagnostic test for MI and can help the clinicians to estimate the severity and size of infarction, to suggest the artery related to the infarct and localize the pathology. The aim of this study is to evaluate the diagnostic value of ECG in posterior MI (PMI) compared with angiographic findings.

METHODS

In a prospective observational study, using simple sampling patients with diagnosis of PMI (ST elevation in at least two consecutive leads V7, V8, and V9) were enrolled and all standard 12 leads and also V7, V8, V9 and right leads, including V3R and V4R were recorded and angiography was performed. ECG changes were recorded and compared with angiography findings.

RESULTS

In this study, totally 138 patients were enrolled (mean ± standard deviation age of 65.00 ± 12.97 and 76.8% male). Left circumflex artery (LCX), right coronary artery (RCA) and left anterior descending artery (LAD) occlusions occurred in 65.9, 50.7, and 29 percent respectively. Patients with LCX occlusion had a significantly higher frequency of ST elevation in V5, V6, I and AVL (P ≤ 0.001). Patients with RCA occlusion had a significantly higher frequency of ST elevation in V1, V3R, and V4R and also ST depression in V5 and V6 (P ≤ 0.001).

CONCLUSION

In PMI, there is a relationship between ECG findings and different coronary artery occlusions. Hence that ECG is a useful tool to predict the LCX or RCA occlusion in PMI.

摘要

背景

心肌梗死（MI）是供需失衡后发生的心肌细胞死亡。心电图（ECG）是诊断MI的一项检查，可帮助临床医生评估梗死的严重程度和范围，提示梗死相关动脉并确定病变部位。本研究的目的是比较心电图在诊断后壁心肌梗死（PMI）方面与血管造影结果的诊断价值。

方法

在一项前瞻性观察性研究中，采用简单抽样法纳入诊断为PMI（至少两个连续导联V7、V8和V9出现ST段抬高）的患者，记录所有标准12导联以及V7、V8、V9和右胸导联（包括V3R和V4R），并进行血管造影。记录心电图变化并与血管造影结果进行比较。

结果

本研究共纳入138例患者（平均年龄±标准差为65.00±12.97岁，男性占76.8%）。左旋支动脉（LCX）、右冠状动脉（RCA）和左前降支动脉（LAD）闭塞分别占65.9%、50.7%和29%。LCX闭塞的患者在V5、V6、I和AVL导联出现ST段抬高的频率显著更高（P≤0.001）。RCA闭塞的患者在V1、V3R和V4R导联出现ST段抬高的频率显著更高，在V5和V6导联出现ST段压低（P≤0.001）。