Krucoff M W, Parente A R, Bottner R K, Renzi R H, Stark K S, Shugoll R A, Ahmed S W, DeMichele J, Stroming S L, Green C E
Division of Cardiology, Georgetown University Hospital, Washington, DC 20007.
Am J Cardiol. 1988 Jun 1;61(15):1232-7. doi: 10.1016/0002-9149(88)91161-7.
Multilead ST-segment recordings taken during percutaneous transluminal coronary angioplasty (PTCA) could function as an individualized noninvasive template or "fingerprint," useful in evaluating transient ischemic episodes after leaving the catheterization laboratory. To evaluate the reproducibility of such ST-segment patterns over time, these changes were analyzed in patients grouped according to the time between occlusion and reocclusion. For the patients in group 1, the study required comparing their "fingerprints" in repeat balloon inflation during PTCA (reocclusion in less than 1 hour), for those in group 2, comparing ST "fingerprints" during PTCA with ST changes during spontaneous early myocardial infarction (reocclusion in 24 hours) and in group 3, comparing ST "fingerprints" with ST changes during repeat PTCA for restenosis greater than 1 month after the initial PTCA. The ST "fingerprints" among the 20 patients in group 1 were identical in 14 cases (70%) and clearly related in another 4 (20%). Of the 23 patients in group 2, 12 (52%) had the same and 8 (35%) had related patterns. Of 19 patients in group 3, 8 (42% had the same pattern and 8 (42%) had related patterns. Thus, ST fingerprints were the same or clearly related with reocclusion in the same patient from less than 1 hour to greater than 1 month after initial occlusion in 87% of patients overall, in 90% in less than 1 hour, in 87% in less than 24 hours and in 84% greater than 1 month later. Multilead pattern ST-segment "fingerprints" may serve as a noninvasive marker for detecting site-specific reocclusion.
经皮腔内冠状动脉成形术（PTCA）期间进行的多导联ST段记录可作为个体化的无创模板或“指纹”，有助于评估离开导管室后的短暂性缺血发作。为了评估此类ST段模式随时间的可重复性，根据闭塞与再闭塞之间的时间对患者进行分组，并分析这些变化。对于第1组患者，该研究要求比较他们在PTCA期间重复球囊扩张时的“指纹”（再闭塞时间少于1小时）；对于第2组患者，比较PTCA期间的ST“指纹”与自发性早期心肌梗死期间的ST变化（再闭塞时间为24小时）；对于第3组患者，比较ST“指纹”与初始PTCA后1个月以上再狭窄的重复PTCA期间的ST变化。第1组的20例患者中，14例（70%）的ST“指纹”相同，另外4例（20%）明显相关。第2组的23例患者中，12例（52%）具有相同模式，8例（35%）具有相关模式。第3组的19例患者中，8例（42%）具有相同模式，8例（42%）具有相关模式。因此，总体而言，87%的患者在初次闭塞后不到1小时至1个月以上的同一患者中，ST指纹相同或与再闭塞明显相关，1小时内为90%，24小时内为87%，1个月后为84%。多导联模式的ST段“指纹”可作为检测特定部位再闭塞的无创标志物。
