Brymer J F, Khaja F, Marzilli M, Goldstein S
J Am Coll Cardiol. 1985 Jul;6(1):41-8. doi: 10.1016/s0735-1097(85)80250-3.
The mechanism of electrocardiographic ST segment changes during acute coronary occlusion was evaluated in 28 consecutive patients with single vessel coronary artery disease undergoing coronary angioplasty. Patients were continuously monitored with a six lead electrocardiogram. Twenty-three patients showed ST changes in the primary zone of occlusion, and 13 of these had additional ST changes in a remote zone. Ten of these 13 had unusually extensive arteries supplying the remote zone. The balloon occluded two adjacent normal arteries in two patients, and no coronary anatomic explanation was evident in one patient. Ten patients with striking primary zone ST changes showed no remote change. Seven had nonextensive primary zone arteries, and three others had abundant collateral vessels. Five patients showed no electrocardiographic changes in primary or remote zones. Four had collateral vessels, and one had left ventricular hypertrophy on the baseline electrocardiogram. It was concluded that remote electrocardiographic changes are probably due to occlusion of unusually extensive coronary arteries and are not simply reciprocal.
在28例接受冠状动脉血管成形术的单支冠状动脉疾病连续患者中，评估了急性冠状动脉闭塞期间心电图ST段改变的机制。患者通过六导联心电图进行连续监测。23例患者在闭塞的主要区域出现ST段改变，其中13例在远离闭塞区域的部位出现额外的ST段改变。这13例患者中有10例为供应远离闭塞区域的动脉异常广泛。在2例患者中，球囊阻塞了两条相邻的正常动脉，1例患者未发现明显的冠状动脉解剖学解释。10例主要区域ST段改变显著的患者未出现远离闭塞区域的改变。7例患者的主要区域动脉不广泛，另外3例有丰富的侧支血管。5例患者在主要或远离闭塞区域均未出现心电图改变。4例有侧支血管，1例基线心电图显示左心室肥厚。得出的结论是，远离闭塞区域的心电图改变可能是由于异常广泛的冠状动脉闭塞所致，并非简单的对应性改变。
