| Object Through the retrospective analysis of acute inferior wall myocardial infarction(MI) cases,clinical distinctions between patients with right coronary artery failure and left circumflex artery failure are ascertained.Methods Of 388 in-hospitalized patients diagnosed with acute inferior myocardial infarction from January 2010 to February 2016 in the Affiliated Hospital of armed police Logistics Institute of cardiovascular department of internal medicine,304 cases are right coronary artery related and 84 are left circumflex artery related—determined through percutaneous coronary intervention(PCI). According to coronary angiography,they are divided into right coronary artery group and left circumflex branch group.The two groups were compared and analyzed in order to cumulatively ascertain distinctions between right coronary artery related and left circumflex artery related acute inferior wall myocardial infarctions.Results 1. Two groups of patients have no significant difference in age, sex, hypertension, diabetes, blood lipids,blood pressure,P > 0.05. 2.Comparison of cardiac function: Killip grading of cardiac function was poorer in the left circumflex artery group at admission,P < 0.05. 3.ECG: ST-segment elevation(?>?),ST-segment elevation(?>?)combined with ST-segment deviation(a VL>?),the ST-segment elevation of V4 R and high degree atrioventricular block of right coronary artery group are 287(94.4%),260(85.5%),120(39.4%),52(17.1%),the left circumflex group34(40.4%),3(3.6%),3(3.6%),1(1.2%),P < 0.05.The left circumflex group STsegment elevation(?>?),ST-segment elevation of V5?V6,ST-segment elevation of V7-9,ST-segment deviation of a VR and ST-segment elevation of ?,a VL are 50(59.6%),62(73.8%),17(20.2%),72(85.7%), right coronary artery group 17(5.6%),18(6.0%),3(1.0%),29(9.5%),P < 0.05. 4.The judgement of the infarct related artery according to ECG: ST-segment elevation(?>?) shows that the sensitivity,positive predictive value of the right coronary artery are 94.4%,89.4%.ST-segment elevation of V4 R shows that the specificity, positive predictive value of the right coronary artery are 96.4%, 97.7%. High degree atrioventricular blockshows that thespecificity,positive predictive value of the right coronary artery are 90.5%,98.1%.ST-segment deviation(a VL>?)shows that shows that the sensitivity, specificity,positive predictive value and negative predictive value of the right coronary artery 84.2%,89.5%,98.1%,62.2%. ST-segment elevation(?>?)shows that the sensitivity,specificity, positive predictive value and negative predictive value of the left cicumflex artery 59.6%,94.4%, 74.6%,89.4%. ST-segment deviation of a VR shows that the sensitivity,specificity, positive predictive value and negative predictive value of the left cicumflex 85.7%, 94.0%, 71.3%, 95.8%. 5.Left ventrical ejection fraction(LVEF)lowered: the left circumflex coronary artery group 46(54.7%),right coronary group 93(30.6%),P<0.05. 6.30 day mortality rate: the left circumflex coronary artery group 9(10.7%),right coronary artery group12(3.9%),P<0.05. The right coronary artery group combined with or without right ventricular infarction(6.7%),4(2.2%),P<0.05.Conclusion 1.Most of acute inferior wall myocardial infarction are caused by RCA,few by LCX. 2.ST-segment elevation(III>II), ST-segment elevation(III>II) combined with STsegment deviation a VL>?,V4 R ST segment elevation and third degree atrioventricular block of ECG in the judgment of right coronary artery disease have very high value. ST-segment deviation of a VR, ST-segment elevation(II>III) combined with ST-segment elevation(V5,V6) in the judgment of left circumflex artery have very high value. 3.The left circumflex artery group have poor admission Killip classification of cardiac function,and its left ventricular ejection fraction is lower and 30-day mortality is higher.The 30-day mortality is higher in patients with right ventricular infarction. |
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