Investigation Of That Correlation Between ST-Segment Changes Of Electrocardiogram And Infarct Related Arteries In Patients With Acute Myocardial Infarction

Objective:By observing the changes of electrocardiogram?ECG?after coronary angiography in hospitalized patients with acute myocardial infarction?AMI?,and the relationship between the infarct-related artery?IRA?confirmed by coronary angiography?CAG?,to analyze the correlation between the characteristic changes and the IRA,and to explore and discuss the causes of the changes,and to determine whether the characteristic ST-segment changes of ECG could prejudge infarct-related artery?IRA?.Methods:This review study strictly followed inclusion and exclusion criteria.627 patients with AMI were selected and divided into the STEMI group and the NSTEMI group.Collecting the baseline information of all patients,18-lead ECG,heart color Doppler ultrasound parameters,Troponin C?cTn?,Creatine Kinase,MB Form?CM-MB?and other laboratory indexes before coronary angiography?CAG?and the coronary angiography operation report.Based on the results of the CAG,the patients in the STEMI group with a single case of the infarct artery were selected and divided into RCA,LCX and LAD groups.To study the correlation between the changes of the characteristic ST-segment and the CAG,so as to determine whether these indicators could help to judge the IRA.To study the correlation between chest lead ST-segment changes and the number of the pathological coronary artery of NSTEMI group.Results:1.With elevation of ST-segment in?,?and aVF,namely clearly diagnosed with acute inferior myocardial infarction?IAMI?,when the single IRA was right coronary artery?RCA?,the ST?_III>?,ST?_aVL>?,ST_V3?/ST_III??1.2,ST???0.05mV,STV_4R??1mV and ST_V6??0.05mV were significantly correlated with angiography,and the Difference?p<0.05?was statistically significant.The first two groups had higher sensitivity and specificity.2.Clearly diagnosed with IAMI,the single IRA was left circumflex artery?LCX?,the ST_aVR??0.1 mV was different from other four groups,has the statistical significance?p<0.05?,but sensitivity and specificity were extremely low.ST?_aVL??and ST_V3?/ST_III?>1.2,the sensitivity and specificity of this two groups were significantly higher than other groups.3.With elevation of ST segment in V1-4 or V1-6,namely clearly diagnosed with acute anterior myocardial infarction?AAMI?,when IRA was left anterior descending branch?LAD?,ST?_????aVF?0.1mV?ST?_??aVL>0.1 mV were strongly correlated?two group,P<0.01?,and the sensitivity,specificity and positive prediction of ST?_????aVF?0.1mV were more significant.4.There was no statistical significance of the number of diseased coronary artery and the depression in precordial ST segment in the AAMI group?p>0.05?.5.There was no statistical significance of the number of diseased coronary artery and the depression in precordial ST segment in the Non-ST-elevation myocardial infarction?NSTEMI?group?p>0.05?.Conclusion:1.For IAMI,in addition to the typical changes in ST-segment,ST?_III>??ST?_aVL>?may assist to judge IRA was RCA.ST?_{a VL??}?ST_V3?/ST_III?>1.2 may assist to judge IRA was LCX.2.For AAMI,in addition to the typical changes in precordial ST-segment,ST?_????aVF?0.1MV and/or ST?_??aVL>0.1 mV may assist to judge that IRA was LAD.3.For AAMI,the depression in precordial ST segment couldn't assist to judge the number of diseased coronary artery.4.For NSTEMI,the depression in precordial ST segment couldn't assist to judge the number of diseased coronary artery.