Giannuzzi P, Temporelli P L, Imparato A, Santoro F, Tavazzi L
Divisione di Cardiologia, Fondazione Clinica del Lavoro, Istituto di Ricovero e Cura a Carattere Scientifico, Veruno.
G Ital Cardiol. 1989 Mar;19(3):189-96.
The value of 12-lead electrocardiogram (ECG) and two-dimensional echocardiography (2D-ECHO, wall motion abnormalities) in recognizing myocardial infarction due to left circumflex and right coronary artery disease was evaluated in 75 patients (aged 26-69 years, within 3 months of myocardial infarction) with single vessel disease (luminal stenosis greater than or equal to 70%). Twenty-five patients (pts) had left circumflex disease and 50 right coronary artery disease. In the group of pts with left circumflex disease, 13 (52%)--group I--showed asynergy limited to the postero-lateral wall and 12 pts (48%)--group II--had more extensive asynergy involving both the postero-lateral and the infero-posterior wall. No pts with left circumflex disease demonstrated asynergy of the interventricular septum. Good correlations were found between the site and extent of asynergy and the location of left circumflex narrowings: 9--group I pts--(69.2%) had obtuse marginal branch disease and 8--group II pts--(67%) had proximal left circumflex disease. Patients with right coronary artery disease were subdivided as follows: group I: 35 pts (70%) with asynergy of infero-posterior wall and posterior septum; group II: 11 pts (22%) with extensive asynergy of infero-posterior, postero-lateral walls and posterior septum; group III: 4 pts (8%) with asynergy limited to the infero-posterior wall. The location of right coronary artery narrowings had no relation to the site and extent of infarct asynergy in pts with single right coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)
在75例(年龄26 - 69岁,心肌梗死3个月内)单支血管疾病(管腔狭窄大于或等于70%)患者中,评估了12导联心电图(ECG)和二维超声心动图(2D - ECHO,室壁运动异常)在识别左旋支和右冠状动脉疾病所致心肌梗死方面的价值。25例患者有左旋支疾病,50例有右冠状动脉疾病。在左旋支疾病患者组中,13例(52%)——I组——表现为仅后侧壁运动不协调,12例(48%)——II组——有更广泛的运动不协调,累及后侧壁和下后壁。没有左旋支疾病患者表现出室间隔运动不协调。运动不协调的部位和范围与左旋支狭窄部位之间存在良好的相关性:9例I组患者(69.2%)有钝缘支病变,8例II组患者(67%)有左旋支近端病变。右冠状动脉疾病患者分为以下几组:I组:35例(70%)下后壁和后间隔运动不协调;II组:11例(22%)下后壁、后侧壁和后间隔广泛运动不协调;III组:4例(8%)仅下后壁运动不协调。在单纯右冠状动脉疾病患者中,右冠状动脉狭窄部位与梗死运动不协调的部位和范围无关。(摘要截短于250字)