Bellamy G R, Rasmussen H H, Nasser F N, Wiseman J C, Cooper R A
Am Heart J. 1986 Aug;112(2):304-9. doi: 10.1016/0002-8703(86)90266-8.
Noninvasive tests for the diagnosis of right ventricular (RV) infarction--two-dimensional echocardiography (2DE), ST elevation in V4R, and clinical parameters--were compared with equilibrium gated blood pool study (GBPS) in 50 patients after acute inferior myocardial infarction. Twenty-two of 50 patients had RV wall motion abnormalities on GBPS and 20 of 50 on 2DE. Sensitivity and specificity of 2DE was 82% and 93%, ST elevation in V4R was 50% and 71%, elevation of venous pressure was 77% and 85%, and a positive Kussmaul's sign was found in 59% and 89% for the detection of RV infarction compared to GBPS. Patients with RV infarction had higher peak creatine kinase levels and lower left ventricular ejection fractions than patients without RV infarction. Three patients died and all had significant left ventricular damage. At 20 weeks' follow-up, two thirds of the patients had no residual RV wall motion abnormalities, and all but two patients showed some recovery.
在50例急性下壁心肌梗死后的患者中，对用于诊断右心室（RV）梗死的非侵入性检查——二维超声心动图（2DE）、V4R导联ST段抬高以及临床参数——与平衡门控心血池显像（GBPS）进行了比较。50例患者中，22例在GBPS上有右心室壁运动异常，20例在2DE上有右心室壁运动异常。与GBPS相比，2DE检测右心室梗死的敏感性和特异性分别为82%和93%，V4R导联ST段抬高分别为50%和71%，静脉压升高分别为77%和85%，出现阳性库斯莫尔征分别为59%和89%。与无右心室梗死的患者相比，右心室梗死患者的肌酸激酶峰值水平更高，左心室射血分数更低。3例患者死亡，均有明显的左心室损害。在20周的随访中，三分之二的患者没有残留的右心室壁运动异常，除2例患者外，所有患者均有一定程度的恢复。
