VECTORCARDIOGRAPHIC MONITORING TO ASSESS EARLY VESSEL PATENCY AFTER REPERFUSION THERAPY FOR ACUTE MYOCARDIAL-INFARCTION

被引:55
作者
DELLBORG, M
STEG, PG
SIMOONS, M
DIETZ, R
SEN, S
VANDENBRANDT, M
LOTZE, U
HAUCK, S
VANDENWIEKEN, R
HIMBERT, D
SVENSSON, AM
SWEDBERG, K
机构
[1] HOP BICHAT, DEPT CARDIOL, F-75877 PARIS, FRANCE
[2] UNIV HEIDELBERG, DEPT CARDIOL, W-6900 HEIDELBERG, GERMANY
[3] UNIV HOMBURG, MED KLIN & POLIKLIN, HOMBURG, GERMANY
[4] ONZE LIEVE VROUW HOSP, AMSTERDAM, NETHERLANDS
关键词
PATENCY; VECTORCARDIOGRAPHY; THROMBOLYSIS; ANGIOGRAPHY;
D O I
10.1093/eurheartj/16.1.21
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Reperfusion therapy has lowered mortality in patients suffering from acute myocardial infarction. Failure to reperfuse is associated with an increased short- and long-term mortality. In a prospective study we used dynamic vectorcardiography to monitor 96 patients with acute myocardial infarction treated with reperfusion therapy to non-invasively assess coronary patency. The results from om continuous monitoring were compared to those obtained from angiography. By using trend-analysis of QRS vector difference and ST vector magnitude, we were able to correctly identify 58 of the 70 patients (83%) with a reperfused infarct-related artery, and 19 of the 26 patients (73%) with a persistently occluded artery demonstrated at an early angiogram (diagnostic accuracy 80%). In patients with high-grade collateral flow to the infarct-related area the results of the vectorcardiographic monitoring and of angiography showed the largest disagreement, whereas the accuracy of vectorcardiographic monitoring was high: 88% among patients without collaterals. Tire present results suggest that QRS complex and ST segment vectorcardiographic monitoring is a useful tool for assessing early coronary artery patency, and that dynamic vectorcardiography may help in identifying candidates for emergency coronary angiography.
引用
收藏
页码:21 / 29
页数:9
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