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右心室梗死的诊断:通过体表等电位图的实验研究

Diagnosis of right ventricular infarction: experimental study through the use of body surface isopotential maps.

作者信息

Sugiyama S, Wada M, Sugenoya J I, Toyoshima H, Toyama J, Yamada K

出版信息

Am Heart J. 1977 Oct;94(4):445-53. doi: 10.1016/s0002-8703(77)80038-0.

Abstract

This investigation was designed to diagnose right ventricular infarction, which is difficult to diagnose by the standard twelve-lead ECG, through the use of body surface isopotential maps which have significant diagnostic information. Right ventricular infarction was experimentally caused by ligation of the canine right coronary artery. Each dog had a series of maps recorded before and a week after experimentally-induced myocardial infarction. The common features of maps in right ventricular infarction are: 1. In the early stage of the ventricular depolarization the negative area occupies a comparatively large part of the right anterior chest surface, and in the middle stage, the larger part of the right anterior surface is also occupied by the negative area. 2. A minimum appears on the right anterior chest surface in the early stage. The delayed excitation resulting from intraventricular conduction disturbance caused by infarction, as verified by the epicardial isochronic map, is also well represented by the body surface isopotential map. In conclusion, through the use of body surface isopotential maps, it is much easier to diagnose right ventricular infarction and intraventricular conduction disturbance caused by infarction even in cases in which the standard twelve-lead ECG does not show the abnormalities clearly.

摘要

本研究旨在通过使用具有重要诊断信息的体表等电位图来诊断右心室梗死,而标准的十二导联心电图很难诊断出右心室梗死。通过结扎犬的右冠状动脉来实验性地诱发右心室梗死。每只狗在实验性心肌梗死前和一周后都记录了一系列的图。右心室梗死图的共同特征是:1. 在心室去极化的早期,负性区域占据右前胸表面的较大部分,在中期,右前表面的较大部分也被负性区域占据。2. 在早期,右前胸表面出现一个最小值。梗死引起的室内传导障碍导致的延迟兴奋,经心外膜等时图证实,体表等电位图也能很好地显示出来。总之,通过使用体表等电位图,即使在标准十二导联心电图未明确显示异常的情况下,也更容易诊断右心室梗死以及梗死引起的室内传导障碍。

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