简介:BackgroundRightbundlebranchblock(RBBB)maypresentasslurredornotchedSwaveinleadV1.However,slurredornotchedSwavemayalsorepresentslowconductioninthemyocardium.MethodsWeretrospectivelyanalyzedtheQRSpatternsinleadsV3RtoV5Rin7patientswithaslurredornotchedSwaveinleadV1.ResultsIntheleadsV3RtoV5R,6patientsshowedincompleteorcompleteRBBBand1patientslurredornotchedSwave.ConclusionsInthemajorityofECGsinasmallpatientserieswithslurredornotchedSwaveinleadV1,QRSmorphologyindicatingincompleteorcompleteRBBBwaspresentinleadsV3RtoV5R.AfindingoffragmentedQRSintheseleadsmayindicateslowconductioninthemyocardium.
简介:BackgroundThefactorsinfluencingtheq-wavechangesinV5andV6duringanterioracutemyocardialinfarction(AMI)havenotbeenthoroughlydescribed.MethodsWestudied70patientswithafirstanteriorAMI,inwhomtheelectrocardiogram(ECG)showedeitherdisappearanceofthenormalseptalqwave(n=24)orpresenceofpathologicalQwaveinV5andV6(n=46)duringfollow-up.TheECGandcoronaryangiographyfindingswerecorrelated.ResultsTherewasnodifferencebetweenthe2groupsintheculpritsiteproximaltoS1(46%vs.36%,P=0.405),buttheculpritsitewasmorefrequentlylocatedproximaltoD1inthegroupwithabnormalQwave(21%vs.67%,P=0.001).Patientswithdisappearanceoftheseptalqwavemoreoftenhadalargeobtusemarginalbranch(46%vs.22%,P=0.037)anddisappearanceoftherwaveinV1(88%vs.7%,P=0.001).PatientswithabnormalQ-wavemoreoftenhadalargeLAD(42%vs.71%),smallrwaveortallorwideRwaveinV1(0%vs.89%,P=0.001)andabnormalQwavesintheinferiorleads(33%vs.59%,P=0.044).ConclusionsInpatientswithfirstanteriorAMI,qwavechangesinV5andV6correlatedwiththemorphologyinV1.EmergingabnormalQwaveinV5/V6predictedtheculpritlesioninalargeLADproximaltoD1,butdisappearanceoftheseptalqwavecouldnotpredicttheculpritlesionproximaltoS1.
简介:“随着药物支架技术的不断进步,冠脉介入再狭窄率获得了持续的下降,使得越来越多的冠心病患者受益于这种微创治疗方式。但美中不足的是,PCI术后仍需要进行长期双抗血小板药物治疗。如果临床科研能显示某些药物支架可缩短双抗血小板治疗疗程,那么患者将可实现既通过急诊PCI术获得梗塞血管的即刻开通,又通过术后药物治疗控制经济负担,同时还可以减少因长期抗血小板治疗伴随的可能出血风险,一举多得。哈医大二院心内科团队最近完成的一项临床科研证实,拥有自主创新专利的BuMA药物洗脱支架可能就是最佳选择之一。”中华医学会心血管分会主任委员、北京大学第一医院霍勇教授于10月13日在2012长城国际心血管会议的BuMA临床研究结果新闻发布会上阐述观点。
简介:目的探讨急性下壁心肌梗死患者心电图胸前导联ST段抬高与冠状动脉造影所示冠状动脉病变的关系及其临床意义.方法187例急性下壁心肌梗死患者,按入院时18导心电图胸前导联ST段改变分为2组,ST段抬高组(16例)和非ST段压低组(171例).所有患者均行冠状动脉造影术,病变适合行经皮腔冠状动脉成型术并检测B型钠尿肽(BNP).结果急性下壁心肌梗死伴胸前导联ST段抬高时多为右冠状动脉近段闭塞,尤其是圆锥支闭塞(P<0.01),且伴有右心功能不全和血流动力学障碍,与下壁右室心梗相比BNP差异有统计学意义(P<0.01).结论急性下壁心肌梗死合并胸前导联ST抬高表明为右冠状动脉近段或开口闭塞且多伴右室心肌梗死和心功能不全.