Famularo M A, Paliwal Y, Redd R, Ellestad M H
Am J Cardiol. 1983 Feb;51(3):440-3. doi: 10.1016/s0002-9149(83)80076-9.
Septal Q-wave amplitudes were studied in lead CM5 to evaluate its utility in predicting segmental coronary artery pathoanatomy. Q-wave amplitudes were measured in 41 patients with coronary artery disease (CAD) before and immediately after treadmill exercise. All patients studied had either significant single-vessel CAD (greater than 70% diameter reduction) or normal coronary anatomy; 13 had left anterior descending (LAD) CAD, 8 had right coronary occlusions, 8 had left circumflex (LC) CAD, and 12 had angiographically normal coronary arteries. Septal Q-wave amplitude measurements at rest and during peak exercise were recorded in 0.5 mm increments and classified as increasing in 20 patients, decreasing in 8, and no change in 13 with exercise. All 13 patients with isolated LAD narrowing had either no change (5 patients) or a decrease (8 patients) in the septal Q wave with exercise. Statistical analysis revealed 62% sensitivity and 100% specificity for single LAD narrowing if a decreasing Q wave was noted with exercise. Patients with isolated right or LC CAD or normal coronary anatomy had mixed septal Q-wave responses to exercise. Only patients with LAD narrowing had reductions in Q-wave amplitude with treadmill exercise. This finding suggests that low Q-wave voltage and its failure to increase after exercise imply abnormal septal activation, reflecting loss of contraction associated with ischemia from LAD narrowing.
研究了CM5导联的间隔Q波振幅，以评估其在预测节段性冠状动脉病理解剖方面的效用。在41例冠心病（CAD）患者进行跑步机运动前及运动后即刻测量Q波振幅。所有研究患者均患有严重的单支冠状动脉疾病（直径狭窄大于70%）或冠状动脉解剖正常；13例患有左前降支（LAD）冠状动脉疾病，8例患有右冠状动脉闭塞，8例患有左旋支（LC）冠状动脉疾病，12例冠状动脉造影正常。静息时和运动高峰时的间隔Q波振幅测量值以0.5毫米的增量记录，并分类为运动后增加的有20例，减少的有8例，无变化的有13例。所有13例孤立性LAD狭窄患者运动时间隔Q波要么无变化（5例），要么减少（8例）。统计分析显示，如果运动时Q波降低，对于孤立性LAD狭窄的敏感性为62%，特异性为100%。孤立性右冠状动脉或LC冠状动脉疾病或冠状动脉解剖正常的患者运动时间隔Q波反应不一。只有LAD狭窄的患者跑步机运动时Q波振幅降低。这一发现表明，低Q波电压及其运动后未能增加意味着间隔激活异常，反映了与LAD狭窄缺血相关的收缩功能丧失。
