Zema M J, Kligfield P
J Electrocardiol. 1979 Jan;12(1):11-5. doi: 10.1016/s0022-0736(79)80039-4.
Forty patients with "poor R wave progression" (PRWP) or "reversed R wave progression" (RRWP) on the electrocardiogram (ECG) who underwent coronary arteriography and left ventriculography within one month of electrocardiographic recording were analyzed. Patients were randomly selected from a population of catheterization proven predominant mitral stenosis with elevated right ventricular pressures (presumed right ventricular hypertrophy), predominant aortic stenosis with increased left ventricular mass (left ventricular hypertrophy) and anterior myocardial infarction (AMI). Application of criteria previously derived from vectorcardiographic (VCG) correlative data, as well as inclusion of right precordial lead repolarization abnormalities, correctly diagnosed 85% (11/13) of angiographic AMIs. It is clinically useful to note that 56% (15/27) of patients with either PRWP or RRWP who did not exhibit angiographic AMI could be identified by 12 lead ECG with only 12% (2/17) false negative AMIs. In comparison with Q wave anterior myocardial infarctions, those with only PRWP or RRWP exhibited a trend toward a less severe degree of contraction abnormality on contrast ventriculography.
对40例在心电图（ECG）记录后1个月内接受冠状动脉造影和左心室造影的心电图表现为“R波进展不良”（PRWP）或“R波进展逆转”（RRWP）的患者进行了分析。患者从经导管检查证实为以右心室压力升高为主的二尖瓣狭窄（推测为右心室肥厚）、以左心室质量增加为主的主动脉瓣狭窄（左心室肥厚）和前壁心肌梗死（AMI）的人群中随机选取。应用先前从心电向量图（VCG）相关数据得出的标准，以及纳入右胸前导联复极异常，正确诊断了85%（11/13）的血管造影确诊的AMI。临床上需要注意的是，12导联心电图可识别56%（15/27）未表现出血管造影确诊AMI的PRWP或RRWP患者，且假阴性AMI仅占12%（2/17）。与Q波前壁心肌梗死相比，仅表现为PRWP或RRWP的患者在对比心室造影时收缩异常程度有较轻的趋势。
