Value of ST segment elevation of aVR lead in patients with acute ST segment elevation myocardial infarction / 中华急诊医学杂志

ABSTRACT

Objective To asses the value of ST segment elevation of aVR lead (aVRSTE) in patients with acute ST segment elevation myocardial infarction (STEMI). Method Myocardial enzymes detection, electrocar-dingraphy, emergency eornary artery angiography, echoeardiography [taken(10±2) days after emergency cornary artery angiography] were obtained and analyzed in 140 consecutive patients with STEMI enrolled in this study. The value of aVRSTE (≥0.05 mV) was assessed for detecting left main stem lesions(defined as ≥50% stenosis of or acute embolism of left main stem)or its equivalent (defined as total or subtotal acute occlusion of left anterior de-scending artery), and predicting the left ventricular systolic function after myocardial infarction. Results The sensitivity, specificity, positive predictive value and negative predictive value of aVRSIE in detection of left main stem lesions were 72.73 % (8/11), 83.72 % (108/129),27.59 % (8/29) and 97.30% (108/111), respectively; in detection of left main stem lesions or its equivalent, they were 41.86 % (18/43), 88.66% (86/97), 62.07 % (18/29), 77.48% (86/111); aVRSYE were combined with STaVR-STv1>0 to detect left main stem lesions, the semi-tivity, specificity, positive predictive value and negative predictive value were 63.64% (7/11),98.45%(127/129),77.78%(7/9),96.95% (127/131). Patients were divided into two groups: groups A with aVRSIE and group B without aVRSYE. KIIJJP class,and left ventricular ejection fraction (LVEF) in group A was higher than those in group B (P<0.05). Conclusions For patients with STEMI: (1) aVRSTE indicated left main stem le-sions or its equivalent; if combined with STaVR-STv1>0, it indicated left main stem lesions more strongly; (2)aVRSTE predicted poorer left ventricular systohc function short time after STEMI.