Abstract:Acute inferior myocardial infarction could result from the occlusion of right coronary artery(RCA) and left circumflex artery(LCX). It may lead to ST segment elevation in all or parts of the inferiorwallinfarctrelated leads in surface electrocardiogram(ECG), accompanied with ST segment changes of adjacent leads, precordial leads, posterior wall leads, right ventricular leads or not. Clinically, it is highly sensitive and specific to locate the culprit vessel of acute inferior myocardial infarction through the changes of ST segment in the above leads, and its different combination and procedure. This paper reviews on the research advance of the culprit vessel location of acute inferior myocardial infarction via surface ECG.
曹正雨, 夏思良. 急性下壁心肌梗死罪犯血管体表心电图定位研究进展[J]. 实用心电学杂志, 2017, 26(1): 57-62.
CAO Zheng-Yu, XIA Si-Liang. Research progress on locating the culprit vessel of acute inferior myocardial infarction by surface electrocardiogram. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2017, 26(1): 57-62.
[1] Chen YL,Hang CL,Fang HY,et al. Comparison of prognostic outcome between left circumflex arteryrelated and right coronary arteryrelated acute inferior wall myocardial infarction undergoing primary percutaneous coronary intervention[J].Clin Cardiol,2011,34(4): 249-253.[2] Geft IL,Shah PK,Rodriguez L,et al.ST elevations in leads V1 to V5 may be caused by right coronary artery occlusion and acute right ventricular infarction[J]. Am J Cardiol,1984,53(8):991-996.[3] Saw J,Davies C,Fung A,et al.Value of ST elevation in lead Ⅲ greater than lead Ⅱ in inferior wall acute myocardial infarction for predicting inhospital mortality and diagnosing right ventricular infarction[J]. Am J Cardiol,2001,87(4):448-450[4] Fiol M,Carrillo A,Cygankiewicz I,et al. New criteria based on ST changes in 12lead surface ECG to detect proximal versus distal right coronary artery occlusion in a case of acute inferoposterior myocardial infarction[J].Ann Noninvasive Electrocardiol,2004,9(4):383-388.[5] Zimetbaum PJ,Krishnan S,Gold A,et al. Usefulness of STsegment elevation in lead Ⅲ exceeding that of lead Ⅱ for identifying the location of the totally occluded coronary artery in inferior wall myocardial infarction[J].Am J Cardiol,1998,81(7):918-919.[6] Kosuge M,Kimura K,Ishikawa T,et al.New electrocardiographic criteria for predicting the site of coronary artery occlusion in inferior wall acute myocardial infarction[J].Am J Cardiol,1998,82(11):1318-1322.[7]Zhan ZQ,Wang W,Dang SY,et al.Electrocardiographic characteristics in angiographically documented occlusion of dominant left circumflex artery with acute inferior myocardial infarction:limitations of ST elevation Ⅲ/Ⅱ ratio and ST deviation in lateral limb leads[J]. J Electrocardiol,2009,42(5):432-439.[8] 李全,程康安,孙璨贤,等.急性下壁心肌梗死时心电图ST段变化与罪犯血管分析[J].中华医学杂志,2011,91(22):1546-1549.[9] Seo DW,Sohn CH,Ryu JM,et al. ST elevation measurements differ in patients with inferior myocardial infarction and right ventricular infarction[J]. Am J Emerg Med,2011,29(9): 1067-1073[10]Hassen GW,Talebi S,Fernaine G,et al.Lead aVL on electrocardiogram: emerging as important lead in early diagnosis of myocardial infarction?[J].Am J Emerg Med,2014,32(7) :785-788.[11] Fiol M,Cygankiewicz I,CarrilloA,e tal. Value of electrocardiographic algorithm based on “ups and downs” of ST in assessment of a culprit artery in evolving inferior wall acute myocardial infarction[J]. Am J Cardiol,2004,94(6):709-714.[12] Turhan H,Yilmaz MB,Yetkin E.Diagnostic value of aVL derivation for right ventricular involvement in patients with acute inferior myocardial infarction[J]. Ann Noninvasive Electrocardiol,2003,8(3):185-188.[13] Assali AR,Sclarovsky S,Herz I,et al. Comparison of patients with inferior wall acute myocardial infarction with versus without STsegment elevation in leads V5 and V6[J].Am J Cardiol,1998,81(1):81-83.[14] Wong CK,Freedman SB.Electrocardiographic identification of the infarctrelated artery in acute inferior myocardial infarction[J].Int J Cardiol,1996,54(1):5-11.[15] Kukla P,Bryniarski L,Dudek D,et al. Prognostic significance of ST segment changes in lead aVR in patients with acute inferior myocardial infarction with ST segment elevation[J].Kardiol Pol,2012,70(2): 111-118.[16] Nair R,Glancy DL. ECG discrimination between right and left circumflex coronary arterial occlusion in patients with acute inferior myocardial infarction:value of old criteria and use of lead aVR[J]. Chest,2002,122(1):134-139.[17] Wellens HJ.The value of the right precordial leads of the electrocardiogram[J].N Engl J Med,1999,340(5):381-383.[18] Kosuge M,Kimura K,Ishikawa T,et al.Implications of the absence of ST-Segment elevation in lead V4R in patients who have inferior wall acute myocardial infarction with right ventricular involvement [J].Clin Cardiol,2001,24(3):225-230.[19] Kosuge M,Ishikawa T Morita S et al.Posterior wall involvement attenuates predictive value of ST-segment elevation in lead V4R for right ventricular involvement in inferior acute myocardial infarction[J]. J Cardiol,2009,54(3):386-393.[20] Kosuge M,Ebina T,Hibi K,et al.Implications of ST-segment elevation in leads V5 and V6 in patients with reperfused inferior wall acute myocardial infarction [J].Am J Cardiol,2012,109(3):314-319.[21] Bayram E,Atalay C.Identification of the culprit artery involved in inferior wall acute myocardial infarction using electrocardiographic criteria[J].J Int Med Res,2004,32(1):39-44.[22] Chia BL,Yip JW,Tan HC,et al. Usefulness of ST elevation Ⅱ/Ⅲ ratio and ST deviation in lead I for identifying the culprit artery in inferior wall acute myocardial infarction[J].Am J Cardiol,2000,86(3):341-343.[23] Jim MH,Tsui KL,Yiu KH,et al.Jeopardised inferior myocardium(JIM) score: an arithmetic electrocardiographic score to predict the infarctrelated artery in inferior myocardial infarction[J]. Ann Acad Med Singapore,2012,41(7):300-304.[24] Tierala I,Nikus KC,Sclarovsky S,et al. Predicting the culprit artery in acute ST-elevation myocardial infarction and introducing a new algorithm to predict infarctrelated artery in inferior STelevation myocardial infarction: correlation with coronary anatomy in the HAAMU Trial[J].J Electrocardiol,2009,42(2):120-127.[25] Hira RS,Wilson JM,Birnbaum Y.Introducing a new algorithm in inferior STsegment elevation myocardial infarction to predict the culprit artery and distinguish proximal versus distal lesions[J]. Coron Artery Dis,2011,22(3):165-170.[26] 王江洪,胡晓军,孙跃玲,等.心电图对急性下壁心肌梗死合并冠状动脉多支病变的判定价值[J].中国介入心脏病学杂志,2015,23(6):333-337.