Warner R A, Battaglia J, Hill N E, Mookherjee S, Smulyan H
Am J Cardiol. 1985 Apr 1;55(8):896-9. doi: 10.1016/0002-9149(85)90713-1.
The scalar electrocardiograms of 64 patients with inferior wall myocardial infarction (MI) and 87 normal subjects were quantitatively analyzed to determine the respective contributions of the initial and terminal portions of the QRS to the diagnosis of inferior MI. Of the 10 best individual electrocardiographic criteria for inferior MI, 7 were Q-wave criteria and 3 were criteria that consisted of delayed termination of the QRS in leads II or III. Combining the best terminal QRS criterion (the QRS in lead III ending at least 20 ms later than the QRS in lead I) with the 7 best Q-wave criteria and the best Q-wave criterion (Q wave 40 ms or longer in lead aVF) with the 3 best terminal QRS criteria, resulted in criteria with better sensitivities and overall diagnostic performances than those of the individual criteria. Analyzing the vectorcardiograms that were also available in 26 of the patients with inferior MI and 34 of the normal subjects showed that the delayed inscription of the end of the QRS in leads II and III in patients with inferior MI is due to redirection of the terminal forces of ventricular depolarization. The terminal portions of the QRS complexes in the limb leads, considered both alone and in conjunction with traditional measurements of Q waves, contain information that is useful for diagnosing inferior MI.
对64例下壁心肌梗死（MI）患者和87例正常受试者的标量心电图进行了定量分析，以确定QRS波起始和终末部分对下壁心肌梗死诊断的各自贡献。在下壁心肌梗死的10项最佳个体心电图标准中，7项是Q波标准，3项是由II或III导联QRS波终末延迟组成的标准。将最佳终末QRS标准（III导联QRS波比I导联QRS波至少晚20毫秒结束）与7项最佳Q波标准相结合，以及将最佳Q波标准（aVF导联Q波40毫秒或更长）与3项最佳终末QRS标准相结合，得到的标准比个体标准具有更高的敏感性和总体诊断性能。对26例下壁心肌梗死患者和34例正常受试者也有的向量心电图进行分析表明，下壁心肌梗死患者II和III导联QRS波终末记录延迟是由于心室去极化终末力的重新定向。肢体导联QRS波群的终末部分，单独考虑以及与传统Q波测量相结合，都包含有助于诊断下壁心肌梗死的信息。
