Abstract:Objective To explore the diagnostic value of electrocardiogram(ECG) for left main coronary artery disease(LMCA-D) by analyzing the 12 lead ECG of acute myocardial infarction(AMI) patients. Methods A total of 4 914 patients were enrolled in our study who had been diagnosed with AMI and undergone coronary arteriography(CAG). In stratified random sampling method and based on CAG results, the sample was divided into LMCA-D group and nonLMCA-D group. We recorded the general clinical data of the two groups and their ECGs in blind measurement. By comparison of ECGs between the two groups, we obtained LMCA-D predictors. Results Binary logistic regression analysis indicated that ST-segment elevation in lead aVR≥0.05 mV(OR:8.160,P<0.05)was an independent predictor of LMCA-D. With a combination of the five noninvasive indices including ST-elevation in lead aVR≥0.05 mV, ST-segment depression in lead V4-V6, the quantity of leads with STsegment depression≥5, low voltage in lead aVF, and QRS complex duration>100 ms, the diagnostic probability of LMCA-D increased from 25.19% to 69.24%. The five indicators identified LMCA-D with positive predictive values of 52.63%, 32.73%, 26.39%, 16.22% and 22.22%, respectively. Conclusion ECG is feasible for predicting LMCA-D in AMI patients and ST-segment elevation in lead aVR≥0.05 mV is quite a favorable ECG indicator. Combination of various indicators helps to improve the diagnostic value of ECG for LMCA-D.
王雨婷. aVR导联对急性心肌梗死中左主干病变的诊断意义[J]. 实用心电学杂志, 2016, 25(3): 188-192.
WANG Yu-Ting. Diagnostic significance of lead aVR for left main coronary artery disease among acute myocardial infarction patients. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2016, 25(3): 188-192.
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