期刊文献+

心电图对于区分透壁心肌梗死和非透壁心肌梗死的可靠性:一项与磁共振成像金标准的对照试验

How reliable is electrocardiography in differentiating transmural from non-transmu-ral myocardial infarction? A study with contrast magnetic resonance imaging as gold standard
下载PDF
导出
摘要 Cardiovascular magnetic resonance(CMR) using contrast enhancement allows exact determination of the site and transmural extent of myocardial infarction(MI). We evaluated whether 12-lead electrocardiography can differentiate transmural from non-transmural MI or determine the site of MI by comparing the findings with those of contrast-enhanced CMR. A total of 27 patients(59.5±12.9 years) with a history of MI(6.4±2.9 months) underwent CMR(Magnetom, Siemens,Erlangen, Germany). Cine images were acquired in the horizontal and vertical long axes and short axis by TrueFISP. Contrast-enhanced CMR images were acquired in the same axes by segmented FLASH 15 min after administration of gadolinium-DTPA(0.15 mmol/kg). This showed the MI to be transmural in 11 patients and nontransmural in 16. An electrocardiogram(ECG) was recorded in all patients before CMR. T-wave alterations, descending ST depression, pathological Q-waves and absent R waves were more frequent in non-transmural MI than transmural MI, as defined by contrast-enhanced CMR (p≥0.618). However, none of the differences were statistically significant. R-wave reduction, q waves and horizontal ST-depression were more frequent in transmural than in non-transmural MI(p≥0.157). Again, the differences were not significant. The sensitivity of the ECG for MI localization was highest in inferior infarctions(85.71%), the specificity was highest in anterior infarctions (100%), the best positive predictive value(80%) was achieved for anterolateral infarctions, and the best negative predictive value for lateral infarctions(95.83%). Transmural and non-transmural MI cannot be differentiated by ECG. The ECG is most accurate in detecting anterolateral MI. Cardiovascular magnetic resonance(CMR) using contrast enhancement allows exact determination of the site and transmural extent of myocardial infarction(MI). We evaluated whether 12-lead electrocardiography can differentiate transmural from non-transmural MI or determine the site of MI by comparing the findings with those of contrast-enhanced CMR. A total of 27 patients(59.5±12.9 years) with a history of MI(6.4±2.9 months) underwent CMR(Magnetom, Siemens,Erlangen, Germany). Cine images were acquired in the horizontal and vertical long axes and short axis by TrueFISP. Contrast-enhanced CMR images were acquired in the same axes by segmented FLASH 15 min after administration of gadolinium-DTPA(0.15 mmol/kg). This showed the MI to be transmural in 11 patients and nontransmural in 16. An electrocardiogram(ECG) was recorded in all patients before CMR. T-wave alterations, descending ST depression, pathological Q-waves and absent R waves were more frequent in non-transmural MI than transmural MI, as defined by contrast-enhanced CMR (p≥0.618). However, none of the differences were statistically significant. R-wave reduction, q waves and horizontal ST-depression were more frequent in transmural than in non-transmural MI(p≥0.157). Again, the differences were not significant. The sensitivity of the ECG for MI localization was highest in inferior infarctions(85.71%), the specificity was highest in anterior infarctions (100%), the best positive predictive value(80%) was achieved for anterolateral infarctions, and the best negative predictive value for lateral infarctions(95.83%). Transmural and non-transmural MI cannot be differentiated by ECG. The ECG is most accurate in detecting anterolateral MI.
  • 相关文献

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部