犬急性右心室心肌梗塞时的右胸心电图变化

Changes in right precordial electrocardiogram during acute right ventricular infarction in dogs

目的：观察犬心大面积右室、左室梗塞时的Ｗｉｌｓｏｎ导联和头胸（ＨＣ）导联右胸心电图变化特征。方法：结扎犬心４支冠状动脉（冠脉），造成大面积右室、左室梗塞并发右心衰竭和心原性休克模型，观察６只犬在正常时、依序结扎每支冠脉后以及第６小时共６个时间段ＷｉｌｓｏｎＶ３Ｒ～Ｖ６Ｒ和相同部位头胸ＨＶ３Ｒ～ＨＶ６Ｒ图形变化。结果：正常犬两种导联图形相似，均呈Ｒ（Ｒｓ）或ｒＳ型；无病理Ｑ波。ＳＴ段抬高、病理Ｑ波和Ｒ波丢失为急性右室心肌缺血和梗塞的敏感指标。在右室小范围缺血早期，仅ＨＶ３Ｒ～ＨＶ６ＲＳＴ段抬高（≥１ｍｍ）达诊断标准，并且抬高幅度始终超过同部位、同时间Ｗｉｌｓｏｎ导联。结论：ＨＣ导联右胸图形的特征性改变较Ｗｉｌｓｏｎ导联更利于右室梗塞的检出。

Objective:To study changes in right precordial electrocardiogram (ECG) during acute right ventricular infarction(ARVI) in dogs.Methods:Large area infarction in right and left ventricles,which resulted in right heart failure and cardiac shock,was induced by occluding 4 coronary arteries in dogs.Right precordial ECG Wilson leads V3R￣V6R and head chest (HC) leads HV3R～HV6R were determined at various time points (normal,ligating every coronary artery,and at 6 hours) in 6 dogs.Results:It showed that right precordial ECG by two methods was similar in R(Rs) or rS pattern in normal dogs,without pathological Q wave.ST segment elevation,pathological Q wave and R wave disappearance were the sensitivity signs of ARVI .Only ST segment elevation (≥1 mm) in HV3R～HV6R achieved diagnostic criterion in the early stage of right ventricular ischemia.The elevation amplitude of ST segments was higher in HV3R～HV6R than that in V3R～V6R at the same time point and location.Conclusions:The characteristic changes of HC leads are superior to Wilson leads in the detection of ARVI.