[代谢综合征中具有特殊心电图模式（Aslanger）的下心肌梗死的特征]。

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologiya Pub Date : 2024-02-29 DOI:10.18087/cardio.2024.2.n2532

A Yu Tretyakov, O V Ermilov, S P Zakharchenko, V A Tretyakova, G V Biryukov, D P Kotova

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引用次数: 0

摘要

目的：评估阿斯朗格模式ST段抬高型心肌梗死与代谢综合征下壁心肌梗死传统形式的特征比较：本研究纳入了 30 名患有代谢综合征的下壁心肌梗死患者：9 名患者具有阿斯朗格心电图模式（第一组，年龄 59.7 [58.4; 63.1] 岁），其余患者具有其中一种传统心电图模式（对照组，年龄 59.9 [57.2; 63.8] 岁，符合代谢综合征的所有标准）。所有患者都接受了经皮介入治疗，并对血管造影进行了评估。在 J 点和 0.06 秒后测量导联 III 的 ST 段抬高幅度，并确定心肌梗死新图像的最佳阈值：结果：阿斯朗格模式的梗死相关动脉多为环状动脉（P=0.0099），冠状动脉血栓形成的特征是 TIMI 血栓分级较低（P=0.014）。阿斯朗格模式的 SYNTAX 值和导联 II≥III ST 基底节段抬高的传统下壁心肌梗死模式的 SYNTAX 值均高于导联 III>II ST 基底节段抬高的类似模式。第 1 组患者入院时（p=0.013）和 24 小时后（p=0.0017）的 cTnI 水平、血小板计数（p=0.0011）和平均体积（p=0.0047）的数值均小于传统下壁心肌梗死患者。阿斯朗格模式的导联Ⅲ在J点和J+0.06 s点的ST段抬高值明显低于传统下壁心梗的导联Ⅲ>Ⅱ和导联Ⅱ≥Ⅲ的ST段抬高值（p<0.001）。J点+0.06 s时的抬高值≤1.5 mm是预测阿斯朗格模式心梗的指标。通过构建 ROC 曲线可以确定，在阿斯朗格模式下，该指数的最佳临界值为 2 毫米：结论：阿斯朗格模式心肌梗死与传统的代谢综合征下心肌梗死相比，具有特殊的血管造影征象、较低的ST段抬高、cTnI水平和血栓形成障碍。

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[Characteristics of Inferior Myocardial Infarction With a Special Electrocardiographic Pattern (Aslanger) in Metabolic Syndrome].

Aim: To evaluate the features of ST-segment elevation myocardial infarction with the Aslanger pattern in comparison with traditional forms of inferior myocardial infarction in metabolic syndrome.

Material and methods: This study included 30 patients with inferior myocardial infarction in the presence of metabolic syndrome: 9 patients with the Aslanger electrocardiographic pattern (group 1, age 59.7 [58.4; 63.1] years) and the rest with one of the traditional forms (control group, 59.9 [57.2; 63.8] years, matched by all criteria of metabolic syndrome). All patients underwent primary percutaneous intervention with assessment of the angiographic picture. The magnitude of ST-segment elevation was measured in lead III at the J point and following 0.06 seconds, and the optimal threshold value of this indicator was determined for a new picture of myocardial infarction.

Results: The infarct-related artery in the Aslanger pattern was more often the circumflex artery (p=0.0099), and coronary thrombosis was characterized by a lower TIMI thrombus grade (p=0.014). SYNTAX values for the Aslanger pattern and for the traditional picture of inferior infarction with ST elevation in lead II≥III were higher than for a similar picture with ST elevation in lead III>II. The level of cTnI at admission (p=0.013) and after 24 hours (p=0.0017), the platelet count (p=0.0011) and mean volume (p=0.0047) in group 1 had smaller values than with traditional inferior infarction. The ST elevation at J point and at J+0.06 s point for lead III with the Aslanger pattern was significantly lower than values of such shift in lead III>II and lead II≥III with traditional inferior infarction (p<0.001). An elevation value ≤1.5 mm at J point +0.06 s was a predictor of infarction with the Aslanger pattern. Constructing the ROC curve made it possible to determine that with the Aslanger pattern, the best cutoff value for this index is 2 mm.

Conclusion: Myocardial infarction with the Aslanger pattern as compared with traditional lower infarction in metabolic syndrome is characterized by specific individual angiographic signs, lower ST segment elevation, cTnI level, and thrombotic disorders.

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.