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首页> 美国卫生研究院文献>Clinical Cardiology >Relation of lateral ST‐segment elevation pattern to myocardial salvage in patients with recanalized anterolateral acute myocardial infarction
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Relation of lateral ST‐segment elevation pattern to myocardial salvage in patients with recanalized anterolateral acute myocardial infarction

机译：再通前外侧急性心肌梗死患者ST段外侧抬高模式与心肌抢救的关系

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Background: Although anterior acute myocardial infarction (AMI) with ST‐segment elevation in lateral leads is associated with a poor prognosis, the significance of the pattern of lateral ST‐segment elevation has not been examined. Hypothesis: The aim of the study was to examine the relation of the pattern of lateral ST‐segment elevation to myocardial reperfusion and infarct size in patients with AMI. Methods: We studied 111 patients who had a first AMI presenting with anterolateral ST‐segment elevation and Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow of the left anterior descending coronary artery within 6 h from symptom onset. Patients were classified into two groups according to the pattern of lateral ST‐segment elevation on the admission electrocardiogram: Group 1, 42 patients with equivalent or greater ST‐segment elevation in lead I than in lead aVL, and Group 2, 69 patients with lesser ST‐segment elevation in lead I in than in lead aVL. Left ventricular ejection fraction (LVEF) was measured by predischarge left ventriculography. Results: There were no differences between the two groups in age, gender, time from onset to recanalization, culprit lesion, or collateral development. Group 1 patients had a higher probability of impaired myocardial reperfusion as indicated by a myocardial blush grade of 0 or 1 after recanalization, a higher peak creatine kinase level, and a lower LVEF than Group 2 patients (p = 0.0001, respectively). Conclusions: We conclude that equivalent or greater ST‐segment elevation in lead I than in lead aVL is associated with impaired myocardial reperfusion and less myocardial salvage in patients with recanalized AMI who present with anterolateral ST‐segment elevation on the admission electrocardiogram.
机译：背景：尽管在前导中伴有ST段抬高的急性急性心肌梗死（AMI）与预后不良有关，但尚未研究ST段抬高的重要意义。假设：该研究的目的是检查AMI患者ST段外侧抬高模式与心肌再灌注和梗死面积的关系。方法：我们研究了111例首发AMI的患者，该患者在症状发作后6小时内出现前外侧ST段抬高和左前降支心肌梗死（TIMI）3级血栓溶解。根据入院心电图上侧ST段抬高的模式将患者分为两组：第1组，42例I导联的ST段抬高高于或等于aVL的患者，第二组，69例较小的患者I线中的ST段抬高高于aVL线中的ST段抬高。左心室射血分数（LVEF）通过放电前左心室造影测量。结果：两组在年龄，性别，从发病到再通的时间，罪魁祸首或侧支发育方面无差异。与第二组患者相比，第一组患者发生再通后心肌脸红等级为0或1，较高的肌酸激酶水平和较低的LVEF，这说明心肌再灌注受损的可能性更高（分别为p = 0.0001）。结论：我们得出结论，在入院心电图上表现为前外侧ST段抬高的再通管AMI患者，I导联的ST段抬高高于或等于aVL导联与心肌再灌注受损和较少的心肌抢救相关。

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