De Hert S, Vrints C, Vanagt E, Snoeck J
Eur Heart J. 1986 Sep;7(9):760-4. doi: 10.1093/oxfordjournals.eurheartj.a062137.
To determine the diagnostic value of R wave amplitude changes occurring during exercise testing after myocardial infarction, exercise ECG's and coronary angiograms were reviewed in 76 postinfarction patients and in 40 patients with normal coronary arteries. During exercise, an increase in R wave amplitude (mean: + 2.7 +/- 1.3 mm) was observed in the postinfarction patients, significantly different (P less than 0.001) from the decrease (mean: - 2.6 +/- 1.1 mm) observed in the group with normal coronary arteries. Although this change increased with the number of diseased coronary arteries, the difference between 1-vessel and multi- or 3-vessel disease was not significant. Extension of infarct size from one to more akinetic segments on the left ventricular angiogram was associated with a significant (P less than 0.001) increase of the R wave amplitude change during exercise (mean: + 1.6 +/- 1.1 vs 3.3 +/- 1.3 mm). It is concluded that the abnormal increase in R wave amplitude observed during exercise testing after myocardial infarction is more strongly related to infarct size then to the number of diseased coronary arteries. Furthermore exercise induced R wave amplitude changes have no diagnostic value in the prediction of multi- or 3-vessel disease in postinfarction patients.
为了确定心肌梗死后运动试验期间R波振幅变化的诊断价值，对76例心肌梗死后患者和40例冠状动脉正常的患者的运动心电图和冠状动脉造影进行了回顾。运动期间，心肌梗死后患者观察到R波振幅增加（平均：+2.7±1.3mm），与冠状动脉正常组观察到的降低（平均：-2.6±1.1mm）有显著差异（P<0.001）。尽管这种变化随病变冠状动脉数量的增加而增加，但单支血管病变与多支或三支血管病变之间的差异不显著。左心室造影显示梗死面积从一个运动减弱节段扩展到更多运动减弱节段与运动期间R波振幅变化显著增加（P<0.001）相关（平均：+1.6±1.1对3.3±1.3mm）。得出的结论是，心肌梗死后运动试验期间观察到的R波振幅异常增加与梗死面积的关系比与病变冠状动脉数量的关系更密切。此外，运动诱发的R波振幅变化对心肌梗死后患者多支或三支血管病变的预测没有诊断价值。
