aVL导联预测急性下壁心肌梗死相关动脉的价值

The lead aVL for predicting the culprit artery in inferior wall acute myocardial infarction

目的 :根据心电图 a VL 导联预测急性下壁心肌梗死相关动脉的价值。方法 :根据冠状动脉造影结果将 49例下壁急性心肌梗死患者分为右冠状动脉闭塞组 3 4例和左冠状动脉回旋支闭塞组 15例。根据 a VL 导联 QRS形态分为 A型 (R≥ 3 S,ST段压低≤ 1mm)和 B型 (R<3 S,ST段压低 >1mm)。结果 : 左冠状动脉回旋支闭塞时 ,a VL 导联呈 A型变化。其敏感度和特异性分别为 80 .0 %和 79.4% ;右冠状动脉闭塞时 ,多呈 B型变化。其敏感度和特异性分别为 79.4%和 80 .0 %。结论 : 下壁急性心肌梗死患者的心电图 a VL 导联 QRS波呈 A型者是左冠状动脉回旋支闭塞的敏感、特异性标志 ;呈 B型者是右冠状动脉闭塞的敏感。

AIM:The aim of this study is to investigate the lead aVL for predicting the culprit artery in inferior wall acute myocardial infarction(AMI). MEHTODS:According to the features of electrocardiogram(ECG)in lead aVL,patients were divided into pattern A( R≥3S,ST segment depression≤1 mm)and pattern B (R<3S,ST segment depression >1 mm). Infarction related arteries (IRA) were divided into entities of right coronary artery (RCA)(34 cases) or left circumflex artery (LCX)(15 cases)confirmed by coronary arteriography in 49 patients with inferior wall AMI. RESULTS: The incidence of pattern A was higher in LCX group than that in RCX group( P <0.05),with the sensitivity and specificity of 80.0% and 79.4% respectively in predicting occlusion of LCX. The incidence of pattern B was higher in RCA group than that in LCX group ( P <0.05) with the sensitivity and specificity of 79.4% and 80.0% respectively in predicting occlusion of RCA. COCLUSION: Pattern A of the QRS complex in lead aVL is a sensitive and specific marker for LCX artery occlusion, whereas pattern B suggests RCA related AMI diseases.