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Residual myocardial jeopardy in patients with Q-wave and non-Q-wave infarctions.

机译:Q波和非Q波梗死患者的残留心肌危险。

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摘要

The correlation between the presence of areas of jeopardized myocardium and the electrocardiographic patterns of anterior and inferior Q-wave and non-Q-wave infarctions was studied in 486 patients who had had stable symptoms for at least six months after a single myocardial infarction. Myocardial jeopardy was identified on a ventriculogram in the right anterior oblique position if normal or hypokinetic wall motion was seen in all segments distal to a lesion that caused stenosis of greater than 50% and less than 100% in the proximal or mid left anterior descending coronary artery (anterior jeopardy), or in the proximal or mid right coronary artery or proximal circumflex coronary artery in a left dominant circulation (inferior jeopardy). Patients with non-Q-wave anterior infarctions had a significant increase in the frequency of jeopardized myocardium when compared with patients with Q-wave inferior or anterior infarctions. The group with non-Q-wave anterior infarction also had a significantly lower percentage of myocardial segments with absent wall motion in the area of infarction than all other groups. This combination of coronary narrowing with retained wall motion may contribute to the increased frequency of reinfarction seen in some studies of non-Q-wave infarction.
机译:在486例单次心肌梗死后至少六个月内症状稳定的患者中,研究了心肌受损区域的存在与前,下Q波和非Q波梗死的心电图模式之间的相关性。如果在病变远端的所有节段均观察到正常或运动不足的壁运动,则在右前斜位的心室图上识别出心肌危险,导致左前降支冠状动脉近端或中段狭窄大于50%且小于100%动脉(前部危险),或右上冠状动脉的近端或中右冠状动脉或左旋支的近端回旋冠状动脉(下危险)。与Q波下或前部梗死的患者相比,非Q波前部梗死的患者发生心肌梗死的频率显着增加。与所有其他组相比,非Q波前梗死组在梗死区域中无壁运动的心肌节段的百分比也显着降低。在一些非Q波梗死的研究中,这种冠状动脉狭窄与保留壁运动的结合可能有助于增加梗死的发生频率。

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