Agetsuma H, Suzuki A, Hirai M, Sano H, Tomita Y, Ichihara Y, Adachi M, Takatsu F, Hayashi H
First Department of Internal Medicine, University of Nagoya School of Medicine, Japan.
Clin Cardiol. 1995 Feb;18(2):73-9. doi: 10.1002/clc.4960180207.
We investigated the usefulness of QRST isointegral maps (I-maps) for detecting posterior myocardial infarction (MI) with and without conduction disturbance. The I-maps were recorded during sinus rhythm and right ventricular (RV) pacing, which simulated left bundle-branch block (LBBB) in 19 patients with and in 20 patients without MI. Data on 608 normal subjects were used as controls. The "-2 SD area," where the QRST integral value was less than the lower limit of the normal range, was assessed by sigma DM (sum of QRST integral values below the normal range). Posterior MI was diagnosed with a sensitivity of 84%, a specificity of 90%, and a diagnostic accuracy of 87%, assuming that MI was present if sigma DM exceeded 50 mVms. During simulated LBBB, when the criterion sigma DM more than 250 mVms was used, the sensitivity, specificity, and diagnostic accuracy were 79, 75, and 77%, respectively. Thus, I-maps may be useful in detecting posterior MI in patients with and without an intraventricular conduction disturbance.
我们研究了QRST等积分图（I图）在检测有无传导障碍的后壁心肌梗死（MI）方面的实用性。在19例有MI和20例无MI的患者中，于窦性心律和右心室（RV）起搏期间记录I图，后者模拟左束支传导阻滞（LBBB）。将608名正常受试者的数据用作对照。通过sigma DM（正常范围以下的QRST积分值总和）评估QRST积分值低于正常范围下限的“-2 SD区域”。假设当sigma DM超过50 mVms时存在MI，则诊断后壁MI的敏感性为84%，特异性为90%，诊断准确性为87%。在模拟LBBB期间，当使用sigma DM大于250 mVms的标准时，敏感性、特异性和诊断准确性分别为79%、75%和77%。因此，I图可能有助于检测有无室内传导障碍患者的后壁MI。
