New Electrocardiographic Criteria for Identification the Culprit Site of Coronary Artery in Inferior Wall Acute Myocardial Infarction

Autor: Li-Ping Chou, 周立平
Rok vydání: 2007
Druh dokumentu: 學位論文 ; thesis
Popis: 95
Background: The culprit coronary artery in inferior wall acute myocardial infarction (AMI) is one of the major factors of determining the clinical outcome. Several electrocardiographic criteria have been proposed to differentiate between the right coronary artery (RCA) and the left circumflex coronary artery (LCX) as culprit artery in inferior wall AMI. Only one previous study had ever used V3/III ratio as a criteria to predict infarct-related artery at three possible sites which had provided more extensively clinical use. This study was designed to identify the three possible sites of coronary artery in inferior AMI by new electrocardiographic criteria. Methods and Results: Seventy-one patients who have no previous myocardial infarction or bundle branch block and whose first electrocardiogram was obtained less than 12 hours after the onset of chest pain were enrolled in this study. These patients were divided into three groups by confirmed coronary angiography, including culprit lesion before (proximal) and after (distal) the right ventricular branch of RCA and LCX. The ratio of ST elevation in lead III to lead II obtained from first surface electrocardiogram was used to determine the criteria. For culprit artery of proximal RCA, distal RCA, and LCX, III/II ratio was 2.1 ± 0.7, 1.6 ± 0.6, 1.0 ± 0.2 (P < 0.0001 ), respectively. According to the data of the receiver operating characteristic plot, III/II ratio > 1.8 was chosen to predict lesion at proximal RCA, III/II ratio was between 1.2 and 1.8 to predict distal RCA, and III/II ratio < 1.2 to predict LCX with sensitivity of 73%, 76%, 75%, and specificity of 88%, 79%, 92%, respectively. Conclusion: The new electrocardiographic criteria with III/II ratio provided a simple, and useful method for early identification the culprit site of coronary artery in inferior wall AMI.
Databáze: Networked Digital Library of Theses & Dissertations
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