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《Journal of Jinzhou Medical University》 2017-01
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The Effects of Leading aVR ST Segment Elevation in Analyzing Infarct-related Artery in Acute Inferior Myocardial Infarction

WEI Fangfang;Department of Cardiovascular,the First Affiliated Hospital of Jinzhou Medical University;  
Objective The complicated part of the analysis of infarct-related artery in acute myocardial infarction is inferior myocardial infarction. This study aims to identify infarct-related artery in inferior myocardial infarction and confirm the location of culprit lesion by the use of ST segment changes in leading aVR. Methods ST segment changes in leading aVR were recorded in 143 patients who were treated as inferior myocardial infarction with ST segment elevation,and then patients were treated with coronary angiogram.The relationship between ST segment changes in leading aVR and infarct-related artery,and the relationship between that and the localization of culprit lesion were investigated respectively. Results ST elevation which was more than or equal to 0. 5 mm in leading aVR was present in 14 patients( 9. 8%),ST segment changes were not significant in 56 patients( 39. 2%) and ST depression which was more than 0. 5 mm was present in 73 patients( 51. 0%). There were 110 patients( 76. 9%) whose IRA were right coronary artery( RCA) and 33 patients( 23. 1%) whose IRA were left circum ex artery( LCX). Prevalence of RCA involvement as IRA was statistically significant among three research groups( 92. 9% in ST elevation group,83. 9% in no obviously changed group and 68. 5% in ST depression group,P = 0. 039). Presence of ST elevation had the sensitivity and speci city of 11. 82% and 96. 97% respectively for detecting RCA lesions. Presence of ST depression had the sensitivity and speci city of 69. 97% and 54. 54% respectively for identifying LCX lesions. Conclusion Presence of ST elevation is highly suggestive of RCA lesions in patients with inferior myocardial infarction,whereas the absence of ST elevation cannot rule out RCA lesions.
【CateGory Index】: R542.22
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