左冠状动脉回旋支病变患者心电图与心血管造影表现的关系

The relationship between electrocardiographic patterns and angiographic features in patients with isolated left circumflex coronary artery disease

报告89例左冠脉回旋支单支血管病变患者心电图(ECG)表现与冠脉病变部位及左室功能的关系。75例(84％)患者有ECG异常表现,下壁导联异常发生率在近端或远端病变患者中相似,但近端或钝缘支病变患者侧壁导联异常发生率明显高于远端患者V_1导联异常R波?≥0.04且R/S>1)多见于近端病变患者。指出在无右室肥厚、束支传导阻滞和预激综合征时,ECGV_1导联异常R波伴下壁或/和侧壁导联Q波有助于临床诊断左冠脉回旋支近端病变,患者多有左室功能异常。

The relationship of electrocardiographie ( ECG) patterns to clinical and angiographic features was assessed in 89 patients with isolated left circumflex coronary artery ( LCX) disease (46 with and 43 without myocardial infarction) . Inferior wall abnormalities on the electrocardiograms were similar in patients with proximal or distal stenoses of the LCX, but an abnormal R wave in lead V1 correlated with proximal LCX stenosis (P<0. 01) . Lateral wall abnormalities were more common in stenoses of the obtuse marginal branch and proximal LCX than in distal stenoses (all P<0. 01 ) . This study suggests that an abnormal R wave in lead V1 associated with lateral wall abnormalities on the standard electrocardiogram may be clinically useful in predicting proximal LCX stenosis and identifying a subset of postinfarction patients with left ventricular dysfunction due to a large infarct size.