Koenig W, Gehring J, Kollmann G, Beckmann R, Mathes P
Dtsch Med Wochenschr. 1982 Nov 5;107(44):1661-7. doi: 10.1055/s-2008-1070183.
For evaluation of a connection between the electrocardiographic diagnosis and localisation of chronic infarction and the angiographic results left ventriculography data of 97 patients with coronary heart disease were assessed quantitatively according to the method of Mathes. According to electrocardiographic criteria of infarction six subgroups were distinguished: anteroseptal, anterior, anterolateral, inferior, inferiolateral, and posterolateral. Asynergies were demonstrable in 87% of patients with infarct electrocardiograms, normal ventricular function was seen in 80% of patients without infarct ECG. Asynergies were seen in 75% of electrocardiographically diagnosed anterior wall infarcts and in 92% of posterior wall infarcts. The sensitivity of the ECG in chronic infarction was 83%, the specificity 84%. Pronounced differences in the number of involved segments were found between inferior and inferiolateral infarction. In contrast, no clear-cut differentiation of electrocardiographic findings judged by segmental involvement in the left ventriculography was seen for the anterior wall. The extent of the anterior wall infarction diagnosed by electrocardiography did not correlate with results of left ventriculography. The ECG is a suitable means for detection of segmental disturbances of contraction also in the chronic infarction stage. However, localisation and extent of the lesion can only be assessed within limits.
为评估心电图诊断与慢性梗死定位之间的关联,采用马泰斯方法对97例冠心病患者的左心室造影数据进行了定量评估。根据梗死的心电图标准,区分出六个亚组:前间壁、前壁、前侧壁、下壁、下侧壁和后侧壁。梗死心电图患者中87%可显示心肌运动不协调,无梗死心电图患者中80%心室功能正常。前壁梗死经心电图诊断者中75%可见心肌运动不协调,后壁梗死经心电图诊断者中92%可见心肌运动不协调。慢性梗死时心电图的敏感性为83%,特异性为84%。下壁梗死和下侧壁梗死受累节段数量存在显著差异。相比之下,前壁在左心室造影中根据节段受累判断的心电图表现无明确差异。心电图诊断的前壁梗死范围与左心室造影结果无关。心电图是检测慢性梗死阶段节段性收缩障碍的合适手段。然而,病变的定位和范围只能在一定限度内进行评估。