ST-segment Elevation In Lead I And AVL Of Electrocardiogram And The Relationship Between Blood Vessels Of Offenders With Acute Myocardial Infarction

ObjectiveTo investigate the location of the culprit vessels in acute myocardial infarction in ST-segment elevation in leads I and a VL.MethodsThis study was conducted at the Department of Cardiology of China-Japan Union Hospital of Jilin University from January 1,2016 to December 31,2017.All patients with electrocardiogram showed high-wall or anterior ST-segment elevation acute myocardial infarction.The basic data,electrocardiogram,and coronary angiography results were collected,and retrospective statistical analysis was performed on the enrolled patients.(1)Patients with ST elevation in lead I and AVL on ECG were divided into two groups: group A,with lesion vessels as the first diagonal branch;group B,with lesion vessels as circumflex branches.(2)Patients with an STG elevation in the anterior wall lead according to whether they combined with ST elevation in leads I and AVL were divided into two groups: Group C,ECG showed anterior wall conduction and I,AVL lead ST segment elevation;D group,ECG showed simple anterior ST leads ST elevation.(3)The patients with occlusion near the descending branch of coronary angiography were divided into two groups according to whether they were combined with ST elevation in leads I and AVL: E group,ECG showed anterior wall conduction combined I and AVL lead ST Segment elevation;group F,ECG showed simple anterior ST leads ST elevation.Electrocardiographic findings and angiographic results were grouped to analyze:(1)ECG characteristics of ST-segment elevation in lead I and a VL in blood vessels of different offenders;(2)ST-segment elevation in lead I and a VL in the anterior wall The value of judging the blood vessels of the infarcted culprit;(3)The relationship between the anatomical obstruction of anterior wall myocardial infarction and ST-segment elevation electrocardiographic manifestations in leads I and a VL.Results(1)The first diagonal branch and circumflex branch occlusion are two possible culprit vessels of simple high lateral wall myocardial infarction.On the electrocardiogram,there are no statistically significant differences between II,V1,and V3-V6 lead depression in the two groups((P>0.05);while the proportion of concomitant III and AVF lead pressure in the diagonal branch was significantly higher than that in the circumflex branch(P<0.05);the proportion of V2 lead depression in the circumflex branch was significantly higher(P<0.05).(2)In patients with anterior myocardial infarction with ST-segment elevation in leads I and a VL,the culprit vessels are the anterior descending coronary artery,and the specificity of high-laterallateral ST-segment elevation in the diagnosis of proximal lesions in the anterior wall myocardial infarction is 90.8% and sensitivity was 20.1%.(3)In patients with anterior MI with proximal occlusion of the anterior descending coronary artery,whether or not I and a VL are elevated is related to the location of the obtuse marginal branch and the diameter of the obtuse marginal limb.The patient with ST-segment elevation in leads I and a VL has an obtuse margin.There is a difference between the branching distance and the obtuse marginal branch diameter compared with the unlifted group.(P<0.01).Conclusion1.Through the performance of electrocardiogram can be a preliminary positioning of the culprit vessels in patients with purely high sidewall myocardial infarction.2.Electrocardiographic elevation of the lateral wall has a predictive value for the lesion site of patients with acute anterior myocardial infarction and is associated with the anatomical characteristics of the relevant vessels.