期刊文献+

aVR导联对非ST段抬高型急性冠脉综合征冠状动脉病变的预测价值 被引量:5

Value of lead aVR in diagnosing the severity of coronary artery lesion in non-ST-elevation acute coronary syndrome
暂未订购
导出
摘要 目的 通过与冠状动脉造影对比,研究aVR导联ST段改变的特征对非ST段抬高型急性冠脉综合征病变血管的预测价值.方法 分析625例非ST段抬高型急性冠脉综合征患者一般资料、心电图、超声心动图及冠状动脉造影结果.结果 aVR导联无ST段抬高组(n=537)、ST段抬高0.05~0.1 mrn组(n=58)、ST段抬高>0.1 mm组(n=30)的左心室射血分数分别为53.6%±7.2%、50.2%±6.8%、48.2%±6.4%,3组比较差异有统计学意义(P=0.003);恶性心律失常(室性心动过速或心室颤动)发生率分别为3.4%、8.6%、13.3%,3组比较差异有统计学意义(P=0.008);病死率分别为2.2%、5.2%、10%,3组比较差异有统计学意义(P=0.026);左主干和(或)三支病变的发生率分别为24.8%、37.9%、56.7%,3组比较差异有统计学意义(P<0.0005).结论 非ST段抬高型急性冠脉综合征患者出现aVR导联ST段抬高对判断左主干或三支病变有预测价值,应引起高度重视. Objectives To assess the value of lead aVR in diagnosing the severity of coronary artery disease in non-ST-elevation acute coronary syndrome (ACS) compared with coronary angiographic outcome.Methods General information,electrocardiogram,color doppler echocardiography and coronary angiographic outcomes of 625 cases with non-ST-elevation ACS were analyzed.Results Among 625 patients with non-ST-elevation ACS,537 had no ST-elevation in aVR,58 had minor (0.05-0.1 mm) ST-elevation in aVR and 30 had major (>0.1 mm) ST-elevation in aVR,their left ventricular ejection fraction (LVEF) were 53.6% ±7.2%,50.2%±6.8% and 48.2% ±6.4%,respectively (P=0.003) ;malignant arrhythmia (ventricular tachycardia or ventricular fibrillation) rates were 3.4%,8.6% and 13.3%,respectively (P=0.008) ; mortality rates were 2.2%,5.2% and 10%,respectively (P=0.026) ; incidences of left main and (or) three-vessel disease (LM/3-vd) were 24.8%,37.9% and 56.7%,respectively (P<0.0005).Conclusions ST-elevation in aVR can be useful in the early identification of LM/3-vd in patients with non-ST-elevation ACS,and it should be highly valued.
出处 《岭南心血管病杂志》 2014年第1期44-47,共4页 South China Journal of Cardiovascular Diseases
关键词 冠状动脉疾病 心电图 冠状动脉造影 coronary artery disease electrocardiography coronary angiography
  • 相关文献

参考文献14

  • 1BRAUNWALD E, ANTMAN E M, BEASLEY J W, et al. ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment myocardial infarction:a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unhable Angina) [J]. J Am Coil Cardiol, 2002, 40(7): 1366-1374.
  • 2ANTMAN E M, ANBE D T, ARMSTRONG P W, et al. ACC/ AHA guidelines for the management of patients with ST elevation myocardial infarction-executive summary:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction) [ J ] .Circulation, 2004, 110 (5) : 588 - 636.
  • 3GORGELS A P, VOS M A, MULLENEERS R, et al. Value of the electrocardiogram in diagnosing the number of severely narrowed coronary arteries in rest angina pectoris [ J ]. Am J Cardiol, 1993, 72(6): 999-1003.
  • 4KOSUGE M, KIMURA K, ISHIKAWA T, et al. Predictors of left main or three-vessel disease in patients who have acute coronary syndromes with non-ST-segment elevation [J]. Am J Cardiol 2005, 95(3) : 1366-1369.
  • 5GAITONDE R S, SHARMA N, ALI-HASAN S, et al. Prediction of significant left main coronary artery stenosis by the 12-lead electrocardiogram in patients with rest angina pectoris and the withholding of clopidogrel therapy [ J ]. Am J Cardiol, 2003, 92(4): 846-848.
  • 6景永明.也谈aVR导联的诊断价值[J].临床心电学杂志,2007,16(6):452-453. 被引量:4
  • 7杜乃立,杜瑞芝.心电图aVR导联ST段变化的临床意义[J].国外医学(心血管疾病分册),2005,32(2):107-109. 被引量:27
  • 8GORGELS A P, ENGELEN D J, WELLENS H J. The electrocardiogram in acute myocardial infarction//FUSTER V, ALEXANDER R W, O'ROURKE R A.Hurst's the Heart [M]. 10th ed. New York: McGraw-Hill, 2000, 6: 1361-1371.
  • 9BARRABES J A, FIGUERAS J, MOURE C, et al. Prognostic value of lead aVR in patients with a first non-ST-segment elevation acute myocardial infarction [J]. Circulation, 2003, 108(9): 814 -819.
  • 10KOSUGE M, KIMURA K, ISHIKAWA T, et al. Combined prognostic utility of ST segment in lead aVR and troponin T on admission in non-STsegment elevation acute coronary syndromes[J]. Am J Cardiol, 2006, 97(8) : 334 -339.

二级参考文献38

共引文献34

同被引文献51

  • 1Akira Tamura.Significance of lead aVR in acute coronary syndrome[J].World Journal of Cardiology,2014,6(7):630-637. 被引量:13
  • 2王龙,郭继鸿,王伟民,朱天刚.aVR、V_1导联心电图对左主干及前降支近端明显狭窄的诊断价值[J].临床心电学杂志,2007,16(2):93-96. 被引量:27
  • 3Astarci P, Price J, Glineur D, et al. Cerebral embolization during percutaneous valve implantation does not occur during balloon inflation valvuloplasty: prospective diffu- sion-weighted brain MRI study [ J ]. J Heart Valve Dis,2013,22( 1 ) :79 - 84.
  • 4Guidez T ,Marechaux S,Pincon C,et al. Addition of B-type natri- uretic peptide to the GRACE score to predict outcome in acute coronary syndrome : a retrospective (development) and prospec- tive (validation) cohort-based study [ J ]. Emerg Med J, 2012,29 (4) :274-279.
  • 5Tuna KM,Tolga KH,Tekin A, et al. Exercise-induced ST-segment elevation in leads aVR and V1 for the prediction of left main dis-ease[J]. Int J Cardiol,2008,128(2) :240.
  • 6Brannwald E, Amman EM, Mareehaux KC, et al. ACC/AHA guide- line update for the management of patients with unstable angina and non-ST-segment myocardial infarction:a report of the Ameri- can College of Cardiology/American Heart Association Task Force on Practice Guidelines ( Committee on the Management of Patients with UnltableAngJna) [J]. J Am Coll Cardio1,2002,40(7 ) :1366- 1374.
  • 7Kosuge M, Ebina T,Hibi K, et al. ST-segment elevation resolution in lead aVR: a strong predictor of adverse outcomes in patients with non-ST-segment elevation acute coronarysyndrome [ J ]. Circ J,2008,72 (7) :1047.
  • 8Yan AT, Yan RT, Kennelly RM, et al. Relationship of ST eleva- tion in lead aVR with angiographic findings and outcomes in non- ST elevation acute coronary syndromes [ J ]. Am Heart J, 2007, 154(1) :171-180.
  • 9Kosuge M, Ebina T, Hibi K, et al. An early and simple predictor of severe left main and/or three-vessel disease in patients with nort-STsegment elevation acute coronary syndrome[ J ]. Am J Car- diol,2011,107 (4) :495-502.
  • 10Reesukumal K, Pratumvinit B. B-type natriuretic peptide not TIMI risk score predicts death after acute coronary syndrome[ J]. J Clin Lab,2012,55(10) : 1017-1022.

引证文献5

二级引证文献16

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部