心血管磁共振成像检出的已愈合心肌梗死部位和心电图模式之间的一致性

作     者：Bayés De Luna A. Cino J.M. Pujadas S. 姜朝晖 

作者机构：Institute of Cardiology Institut Catal de Ciencias Cardiovasculares Service of Cardiology Hospital Sant Pau Barcelona Spain Dr. 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第2卷第6期

页      面：31-32页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1002[医学-临床医学] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：心血管磁共振成像 Q波心肌梗死 梗死部位 心电图 一致性 急性冠状动脉综合征 愈合 检出 ST段抬高型 梗死区域 

摘      要：Q- wave myocardial infarction(MI) location is generally based on a pathologic correlation first proposed 50 years ago. Despite the proved reliability of contrast- enhanced cardiovascular magnetic resonance(CE- CMR) imaging to detect and locate infarcted areas, no global study has been conducted with the aim of correlating the electrocardiographic(ECG) patterns of Q- wave MI with infarct location. We studied this correlation in 51 patients with ST- elevation acute coronary syndrome who presented with Q waves or equivalents during MI. Seven preestablished ECG patterns that matched with high specificity to 7 different MI locations as detected by CE- CMR imaging were used to assess its value in clinical practice to locate an infarcted area. There were 4 ECG patterns in the anteroseptal zone(23 patients; septal, apical, and/or anteroseptal, extensive anterior, and limited anterolateral) and 3 ECG patterns in the inferolateral zone(28 patients; lateral, inferior, and inferolateral). In conclusion,(1) the predefined ECG patterns we used matched well(86% global concordance) with their corresponding infarction areas as detected by CE- CMR imaging and have real value in clinical practice, and(2) the RS morphology in lead V1 is due to lateral MI and the QS morphology in lead aVL is due to mid- anterior and mid- lateral MI. Therefore, the terms posterior and high lateral infarction are incorrect and should be changed to lateral wall and limited anterolateral wall MI.