Akut inferior miyokard infarktüsünde sorumlu arterin öngörülmesinde yeni EKG kriterleri
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Date
2004-03-15
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Uludağ Üniversitesi
Abstract
İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık %99 olguda koroner ateroskleroza bağlıdır. Akut miyokard infarktüsünde yüzey EKG ile sorumlu arterin tespiti birçok çalışmada araştırılmış, EKG kriterleri tek tek ve kombine olarak çalışılmış, fakat ideal kriter veya kriterler tanımlanamamıştır. Biz bu çalışmada akut inferior miyokard infaktüsünde yüzey EKG’sini kullanarak erken dönemde infarktüsten sorumlu arteri tespit etmeyi amaçladık. Pratik olarak kullanılabilecek 2 kriter tek tek ve kombine olarak değerlendirildi. Bu kriterler şöyle idi: A) DIII’te ST elevasyonu > DII’de ST elevasyonu ise ve B) aVL’de ST depresyonu > DI’de ST depresyonu. Çalışmaya 41 akut inferior miyokard infarktüslü hasta dahil edildi. Kriter A ve kriter B’nin sağ koroner arter lezyonunu belirlemedeki sensitivite ve spesifisitesi yüksek saptanmasada her iki kriter beraber kullanıldığında yüksek spesifisite gösterdi. Sonuç olarak, bu çalışmamızda EKG kriterleri ile akut inferior miyokard infarktüsünde infarkttan sorumlu arterin tahmin edilebileceğini gösterdik. İnfarktüsten sorumlu arterin erken ve doğru tanımlanabilmesi risk altındaki miyokard miktarını öngörebilmemize, klinik riski tahmin edebilmemize ve acil revaskülarizasyon için harekete geçmemize yardımcı olur.
Ischemic heart disease is an important cause of morbidity and mortality and 99% of the cases are caused by coronary atherosclerosis. Predicting the culprit coronary artery in inferior wall acute myocardial infarction by surface ECG has been assessed in numerous studies, in which ECG criteria have been used either one by one or together, however the ideal criteria have not been defined. In this trial we aimed to predict the culprit coronary artery in the early stage in inferior wall acute myocardial infarction by using surface ECG. The two criteria, which can be used pratically, was studied one by one and together. These criteria included A) ST elevation at DIII > ST elevation at DII and B) ST depression at aVL > ST depression at DI. Forty-one patients with inferior myocardial infarction have been included in the trial. Fischer chi-square test was used as the istatistical analysis. Although the sensitivity or spesifisity of the criteria A or B in assessing the right coronary artery lesion was not high, using both criteria together showed high specifity. In conclusion, our study showed that the culprit artery in acute inferior myocardial infarction could be predicted by using ECG criteria. Early and right determination of the culprit infarct artery enables us to assess the myocardial area under risk, to estimate the clinical risk and to get ready for an urgent revascularization.
Ischemic heart disease is an important cause of morbidity and mortality and 99% of the cases are caused by coronary atherosclerosis. Predicting the culprit coronary artery in inferior wall acute myocardial infarction by surface ECG has been assessed in numerous studies, in which ECG criteria have been used either one by one or together, however the ideal criteria have not been defined. In this trial we aimed to predict the culprit coronary artery in the early stage in inferior wall acute myocardial infarction by using surface ECG. The two criteria, which can be used pratically, was studied one by one and together. These criteria included A) ST elevation at DIII > ST elevation at DII and B) ST depression at aVL > ST depression at DI. Forty-one patients with inferior myocardial infarction have been included in the trial. Fischer chi-square test was used as the istatistical analysis. Although the sensitivity or spesifisity of the criteria A or B in assessing the right coronary artery lesion was not high, using both criteria together showed high specifity. In conclusion, our study showed that the culprit artery in acute inferior myocardial infarction could be predicted by using ECG criteria. Early and right determination of the culprit infarct artery enables us to assess the myocardial area under risk, to estimate the clinical risk and to get ready for an urgent revascularization.
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Keywords
Miyokard infarktüsü, İnfarkttan sorumlu arter, Elektrokardiyografi, Myocardial infarction, Culprit infarct artery, Electrocardiography
Citation
Çiçek, D. vd. (2004). "Akut inferior miyokard infarktüsünde sorumlu arterin öngörülmesinde yeni EKG kriterleri". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 30(1), 17-20.