The electrocardiogram characteristics of left circumflex artery as infarction related artery in acute myocardial infarction
GUO Chen-Xian, SHEN Zhi-Jie, WANG Xiao-Long
(1.Department of Cardiology, Wujin Hospital of Chinese Traditional Medicine, Changzhou Jiangsu 213161; 2. Department of Cardiology, Shuguang Hospital不从心Affiliated to Shanghai University of Chinese Traditional Medicine, Shanghai 201203, China)
Abstract：Objective To analyze the electrocardiogram characteristics of left circumflex artery as infarction related artery(IRA) in acute myocardialinfarction. Methods 94 cases of acute myocardial infarction with infarction related artery of left circumflex artery(LCX) and right coronary artery (RCA) patients were collected from January 2010 to July 2013 in Shuguang hospital affiliated to Shanghai university of traditional Chinese medicine. The emergency electrocardiogram characteristics of patients were retrospectively analyzed with ST segment changes in lead Ⅰ, aVL; lead of inferior 8wall (Ⅱ,Ⅲ,[LM]aVF) and chest leads. Comparison of STⅡand STⅢwas measured under the condition when IRA was LCX or RCA with elevated ST segment in theinferior wall. Results Among the full set of patients with acute myocardial infarction, IRA with LCX counted for 30 cases while IRA with RCA, 64 cases. (i) Correlation analysis of lead Ⅰ, aVL with IRA: Lead Ⅰ depression in IRALCX, 3 cases; nondepression 27 cases. Lead Ⅰ depression in IRARCA, 22 cases; non-depression 42 cases with statistically significance in two groups (P=0.013).Lead aVL depression in IRALCX, 3cases; nondepression 27 cases.Lead aVL depression in IRARCA, 26 cases; nondepression 38 cases with statistically significance in two groups (P=0.003). (ii) Correlation analysis of lead Ⅱ,Ⅲ, aVF with IRA: Lead of inferior wall elevation in IRALCX, 10 cases; nonelevation 20 cases. Lead of inferior wall elevation in IRARCA, 51 cases; nonelevation 13 cases with statistically significance in two groups (P<0.01). While ST elevated in both IRA for RCA and LCX, IRALCX,STⅡ≥STⅢ 7 cases; STⅢ>STⅡ 3 cases; IRARCA, STⅡ≥STⅢ 15 cases; STⅢ>STⅡ 36 cases with significant statistically meaning (P<0.05). (iii) Correlation analysis of chest lead V1-V9 for IRA, non-statistically meaning was measured. Conclusion IRA for LCX in acute myocardial infarction may have such characteristics as neither obvious depression in lead Ⅰ, aVL; nor obvious elevation in lead Ⅱ,Ⅲ,aVF. While both IRA for LCX and RCA with inferior wall elevation , IRALCX is likely to be STⅡ≥STⅢ.
郭晨贤, 沈智杰, 王肖龙. 左回旋支作为急性心肌梗死时梗死相关动脉的心电图特征[J]. 实用心电学杂志, 2015, 24(6): 419-422.
GUO Chen-Xian, SHEN Zhi-Jie, WANG Xiao-Long. The electrocardiogram characteristics of left circumflex artery as infarction related artery in acute myocardial infarction. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2015, 24(6): 419-422.
[1] 欧阳南翔，齐国先.梗死相关动脉为回旋支的急性心肌梗死心电图表现[J].心血管病学进展，2013，34（5）：655-657.[2] Aqel RA，Hage FG，Ellipeddi P，et al.Usefulness of three posterior chest leads for the detection of posterior wall acute myocardial infarction[J]. Am J Cardiol，2009，103(2):159-164.[3] 王梅，王春梅，王成钢，等.糖化血红蛋白与直接冠状动脉介入术后氯吡格雷抵抗关系[J]中华实用诊断与治疗杂志，2013，27（3）：250-252.[4] 郭一力，孟跃，李继红，等.心电图正常范围急性心肌梗死冠状动脉造影和心肌酶特点 [J].中国病案，2012，13（11）：74-75.[5] Christ T，Grubitzsch H，Claus B，et al. Hemodynamic behavior of stentless aortic valves in long term followup[J]. J Cardiothorac Surg，2014，9:197.[6] 许玉韵，胡大一.心电图与冠状动脉造影[M].北京:人民卫生出版社，2006: 34，43-44．[7] Kim SS，Choi HS，Jeong MH，et al. Clinical outcomes of acute myocardial infarction with occluded left circumflex artery[J]. J Cardiol， 2011，57(3)：290-296.[8] 李星虹，莫新玲，谢福生，等. 碎裂QRS波与冠心病患者冠脉病变的关系[J].广东医学，2010，31（8）：996-998.[9] 王江洪，胡小军，孙跃玲，等.心电图“镜面”导联ST段改变对前壁心肌梗死相关血管的判定价值[J].临床急诊杂志，2015，16（3）:172-174.[10] 高岩萍.心肌梗死超急期不典型心电图分析[J].临床心电学杂志，2014，23（5）：351-353.
2015, Vol. 24 
