[Deviation of ST-segment and detection of infarction related artery in patients with acute inferior wall infarction].

To explore the characteristics of ST-segment deviation in patients with acute ST elevation myocardial infarction(STEMI)having only one vessel lesion in either left circumflex artery (LCX) or right coronary artery (RCA).All AMI (acute myocardial infarction) patients were admitted into Peking Union Medical College Hospital from January 1996 to March 2009. They underwent coronary angiography (CAG). And the IRA (infarction-related artery) was either LCX or RCA without other coronary artery stenosis. Their ST-segments deviations on electrocardiogram (ECG) were analyzed quantitatively.Among 2503 AMI cases undergoing CAG during hospitalization, 75 cases had LCX (n = 16) or RCA (n = 59)-related STEMI. The RCA group was further divided into the proximal subgroup (n = 21) and the distal subgroup (n = 38). RCA as IRA was diagnosed when ST I depression < 0, ST V(1) elevation ≥ 0 or ST I and aVL depression < 0 with the sensitivities of 55.9%, 74.6% and 54.2% and the specificities of 81.3%, 62.5% and 81.3% respectively. LCX as IRA was diagnosed when ST aVR depression ≥ 0.1 mv, ST I elevation ≥ 0 or ST V(5) and V(6) elevation ≥ 0 with the sensitivities of 68.8%, 81.3% and 31.3% and the specificities of 76.3%, 59.3% and 91.5% respectively. Proximal occlusion of RCA was diagnosed when there was no ST depression in V(1) and depression in V(2), Max precordial ST depression in V(1)-V(3) with the sensitivities of 47.6% and 52.4% and the specificities of 78.9% and 84.2%.While discriminating IRA in STEMI patients with single LCX or RCA lesion, it is necessary to assess all ST-segments deviations on ECG.