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首页> 外文期刊>The American Journal of Cardiology >Comparison of value of leads from body surface maps to 12-lead electrocardiogram for diagnosis of acute myocardial infarction.
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Comparison of value of leads from body surface maps to 12-lead electrocardiogram for diagnosis of acute myocardial infarction.

机译：从体表到12导联心电图的导联值比较，以诊断急性心肌梗塞。

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We aimed to develop 12-lead electrocardiographic (ECG) models testing ST-elevation criteria with QRST variables and compare their performance with the 80-lead body surface map (BSM) in detection of acute myocardial infarction (AMI). Because the prevalence of non-ST-elevation AMI is increasing worldwide, advances in early ECG detection of AMI are urgently needed. The study population was 755 consecutive patients presenting with ischemic chest pain from January 2002 to June 2004. All patients had electrocardiography and body surface mapping performed at initial presentation. AMI occurred in 519 patients (69%, cardiac troponin T or I level > or =0.1 ng/ml). Of these 519 patients, 303 (58%) had no ST-elevation on the initial 12-lead electrocardiogram. Ten patients were classified as having an "aborted AMI" and were included in the AMI analysis. The American College of Cardiology/European Society of Cardiology criteria for ST-elevation on 12-lead electrocardiogram identified 236 patients with AMI (sensitivity 45%, specificity 92%). Additional QRST features improved sensitivity (51% to 68%) but with decreased specificity (71% to 89%), with the optimal multivariate ECG model having a c-statistic of 0.75. The optimal BSM model identified 402 patients as having AMI (sensitivity 76%, specificity 92%, c-statistic 0.84). This improvement in sensitivity over the 12-lead electrocardiogram was due mainly to detection of ST-elevation in the high right anterior, posterior, and right ventricular territories and AMI in the presence of left bundle branch block. In conclusion, QRST variables added to criteria for ST-elevation result in improvement in sensitivity of the 12-lead electrocardiogram, although with decreased specificity. The BSM is superior in detecting AMI and demonstrates the importance of electroanatomic evaluation of patients with acute coronary syndromes.
机译：我们旨在开发12导联心电图（ECG）模型，以ST升高标准和QRST变量进行测试，并将其与80导联体表（BSM）的性能进行比较，以检测急性心肌梗死（AMI）。由于全世界范围内非ST段抬高型AMI的患病率正在上升，因此迫切需要早期心电图检测AMI的进展。研究人群为从2002年1月至2004年6月连续755例出现缺血性胸痛的患者。所有患者在初次就诊时均进行了心电图检查和体表测绘。 519例患者发生AMI（69％，心肌肌钙蛋白T或I水平>或= 0.1 ng / ml）。在这519名患者中，有303名（58％）在最初的12导联心电图上没有ST升高。十名患者被归类为“流产AMI”，并被纳入AMI分析。美国心脏病学会/欧洲心脏病学会关于12导联心电图ST升高的标准确定了236例AMI患者（敏感性为45％，特异性为92％）。附加的QRST具有改善的敏感性（51％至68％），但特异性降低（71％至89％），最佳多元ECG模型的c统计量为0.75。最佳BSM模型确定402例患有AMI的患者（敏感性为76％，特异性为92％，c统计值为0.84）。与12导联心电图相比，灵敏度的提高主要是由于在存在左束支传导阻滞的情况下，在右前，后和右心室高区域以及AMI中检测到ST抬高。总之，尽管特异性降低，但QRST变量添加到ST升高标准中可改善12导联心电图的敏感性。 BSM在检测AMI方面具有优势，并证明了对急性冠脉综合征患者进行电解剖评估的重要性。

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