Madias J E, Hood W B
J Electrocardiol. 1976;9(4):315-20. doi: 10.1016/s0022-0736(76)80023-4.
In order to assess the relative significance of precordial ST-segment elevations and depressions, 32 patients with anterior transmural myocardial infarction were studied utilizing serial 49-lead precordial maps. Theoretically, zones of ST-segment depression adjacent to major zones of ST-segment elevation might represent border areas of mild ischemia, and hence could be more readily amenable to intervention therapy. As expected, an extensive zone of ST-segment elevation was observed precordially in each of these patients. However, zones of ST-segment depression in adjacent areas were noted to occur inconsistently, were limited in distribution and magnitude, and bore no fixed relationship to zones of ST-segment elevation. Thus, mapping of precordial ST-segment depression in anterior transmural infarction probably has a limited role in assessing evolution of ischemic injury or therapy in these patients. This finding does not, however, vitiate the significance of ST-segment depressions in angina, intermediate coronary syndrome, or non-transmural infarction, conditions which may deserve further study using mapping techniques.
为了评估胸前导联ST段抬高和压低的相对意义，利用连续49导联胸前心电图对32例前壁透壁性心肌梗死患者进行了研究。从理论上讲，与ST段抬高的主要区域相邻的ST段压低区域可能代表轻度缺血的边缘区域，因此可能更容易接受干预治疗。正如预期的那样，在这些患者中的每一位胸前导联均观察到广泛的ST段抬高区域。然而，相邻区域的ST段压低区域出现不一致，分布和程度有限，并且与ST段抬高区域没有固定关系。因此，前壁透壁性梗死时胸前导联ST段压低的心电图描记在评估这些患者缺血损伤的演变或治疗中可能作用有限。然而，这一发现并不削弱ST段压低在心绞痛、中间冠状动脉综合征或非透壁性梗死中的意义，这些情况可能值得使用心电图描记技术进行进一步研究。
