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在前壁急性心肌梗死接受或未接受再灌注治疗后,Q波消退与梗死相关动脉通畅情况、左心室射血分数或容积无关。

Q-wave regression unrelated to patency of infarct-related artery or left ventricular ejection fraction or volume after anterior wall acute myocardial infarction treated with or without reperfusion therapy.

作者信息

Iwasaki K, Kusachi S, Hina K, Yamasaki S, Kita T, Endo C, Tsuji T

机构信息

Cardiovascular Center, Sakakibara Hospital, Okayama University Medical School, Japan.

出版信息

Am J Cardiol. 1995 Jul 1;76(1):14-20. doi: 10.1016/s0002-9149(99)80793-0.

Abstract

We examined the relation of Q-wave regression to left ventricular (LV) indexes in acute anterior wall myocardial infarction (AMI) in relation to reperfusion therapy. A total of 94 patients with their first anterior wall AMI (segment 6 or 7 occlusion according to the American Heart Association classification) were examined. The follow-up period with 12-lead electrocardiograms ranged from 6 to 60 months (mean 24 +/- 18). An abnormal Q wave was defined as > 40 ms and > 25% of the R-wave amplitude. Q-wave regression was defined as Q-wave disappearance and r-wave regression > 0.1 mV in > or = 1 lead. Contingency tables with the chi-square test and analysis of variance were used for assessment of the relation between Q-wave regression and angiographic and clinical indexes. Q-wave regression in > or = 1 lead was found in 77% of the patients. The incidence of Q-wave regression in patients with patent infarct-related artery (81%) was not significantly different from that in those with an occluded lesion (67%). Q-wave regression appeared within 1 month in 60% of patients with a patent infarct-related artery but in 25% of those with an occluded lesion. No difference in the incidence of Q-wave regression was seen between patients with lesions at segments 6 (81%) and 7 (70%), or between those with (75%) and without (77%) collateral circulation. Q-wave regression did not correlate with LV ejection fraction, LV end-diastolic or end-systolic volumes, or regional wall motion.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们研究了急性前壁心肌梗死(AMI)患者中Q波消退与左心室(LV)指标的关系,并与再灌注治疗相关。共检查了94例首次发生前壁AMI的患者(根据美国心脏协会分类,梗死部位为6或7段闭塞)。12导联心电图的随访期为6至60个月(平均24±18个月)。异常Q波定义为时限>40毫秒且幅度> R波幅度的25%。Q波消退定义为Q波消失且在≥1个导联中r波回升>0.1毫伏。使用列联表、卡方检验和方差分析来评估Q波消退与血管造影及临床指标之间的关系。77%的患者在≥1个导联中出现Q波消退。梗死相关动脉通畅的患者中Q波消退的发生率(81%)与梗死相关动脉闭塞的患者(67%)相比无显著差异。梗死相关动脉通畅的患者中60%在1个月内出现Q波消退,而梗死相关动脉闭塞的患者中这一比例为25%。6段(81%)和7段(70%)病变的患者之间,以及有(75%)和无(77%)侧支循环的患者之间,Q波消退的发生率均无差异。Q波消退与左心室射血分数、左心室舒张末期或收缩末期容积或局部室壁运动均无相关性。(摘要截短至250字)

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