Herlitz J, Hjalmarson A
Clin Cardiol. 1985 Mar;8(3):141-7. doi: 10.1002/clc.4960080304.
In 587 patients with acute myocardial infarction (AMI) and no previous MI, electrocardiographically estimated infarct size was related to 1- and 2-year mortality. The overall mortality was higher in patients with transmural MI (Q- or R-wave changes in standard ECG) than in patients with subendocardial infarction (ST-T-wave changes in standard ECG) after 1 year (18.8% compared to 6.5% p less than 0.001) and after 2 years (22.2% compared to 13.8%, p = 0.049). When patients who were alive during primary hospitalization were analyzed separately, slightly higher mortality was found in patients with transmural MI than in subendocardial MI after 1 year (9.6% compared to 4.2%, p = 0.076) while no difference was found after 2 years (13.4% as compared to 11.7%, p greater than 0.2). In a subgroup of patients with anterior MI, precordial mapping with 24 chest leads was analyzed 4 days after arrival in hospital (n = 197). Patients were divided into quartiles according to the sum of R waves, the sum of Q waves, and the number of Q waves. There was a similar overall mortality in each quartile after 1 year and after 2 years regardless of ECG parameters studied. Neither did we find any correlation between the sum of R waves in leads II, III, and aVF on the fourth day in patients with inferior MI and overall 1- or 2-year mortality rate, although there was a trend towards higher mortality with more ECG changes.
在587例既往无心肌梗死（MI）的急性心肌梗死（AMI）患者中，心电图估计的梗死面积与1年和2年死亡率相关。透壁性心肌梗死（标准心电图出现Q波或R波改变）患者1年后的总体死亡率高于心内膜下梗死（标准心电图出现ST-T波改变）患者（分别为18.8%和6.5%，p<0.001），2年后也是如此（分别为22.2%和13.8%，p=0.049）。对在初次住院期间存活的患者进行单独分析时，发现透壁性心肌梗死患者1年后的死亡率略高于心内膜下心肌梗死患者（分别为9.6%和4.2%，p=0.076），而2年后未发现差异（分别为13.4%和11.7%，p>0.2）。在一组前壁心肌梗死患者中，入院4天后（n=197）分析了24个胸导联的胸前区心电图。根据R波总和、Q波总和及Q波数量将患者分为四分位数。无论所研究的心电图参数如何，各四分位数患者1年和2年后的总体死亡率相似。在下壁心肌梗死患者中，第4天II、III和aVF导联R波总和与总体1年或2年死亡率之间也未发现相关性，尽管随着心电图改变增多有死亡率升高的趋势。
