Herlitz J, Hjalmarson A
Clin Cardiol. 1985 Dec;8(12):630-5. doi: 10.1002/clc.4960081204.
In 587 patients with a first myocardial infarction (MI) the electrocardiographically (ECG) estimated infarct size was related to morbidity during a two-year follow-up. Patients with transmural MI (Q- or R-wave changes in standard ECG) were more often treated for heart failure and returned to work less frequently than patients with subendocardial MI (ST-T-wave changes only). There were trends indicating a higher reinfarction rate in patients with subendocardial MI, whereas angina pectoris was observed as frequently in both groups. In a subset of patients with anterior MI, infarct size was estimated from the total Q- and R-wave amplitude in 24 precordial leads 4 days after arrival in hospital. A positive relationship was observed between ECG-estimated infarct size and treatment for heart failure, and patients with smaller infarctions according to ECG criteria returned to work less frequently. A higher reinfarction rate was observed in patients with smaller infarctions. In patients with inferior MI there were mostly weaker correlations between ECG-estimated infarct size (Q- and R-wave changes in leads II, III, and a VF) and morbidity during the two-year follow-up.
在587例首次发生心肌梗死（MI）的患者中，通过心电图（ECG）估算的梗死面积与两年随访期间的发病率相关。透壁性心肌梗死患者（标准心电图出现Q波或R波改变）因心力衰竭接受治疗的频率更高，重返工作岗位的频率低于心内膜下心肌梗死患者（仅出现ST-T波改变）。有趋势表明心内膜下心肌梗死患者的再梗死率更高，而两组心绞痛的发生率相当。在一部分前壁心肌梗死患者中，入院4天后根据24个胸前导联的总Q波和R波振幅估算梗死面积。观察到ECG估算的梗死面积与心力衰竭治疗之间呈正相关，根据ECG标准梗死面积较小的患者重返工作岗位的频率较低。梗死面积较小的患者再梗死率较高。在下壁心肌梗死患者中，ECG估算的梗死面积（II、III和aVF导联的Q波和R波改变）与两年随访期间的发病率之间的相关性大多较弱。
