Detection and quantification of acute myocardial ischemia by morphologic evaluation of QRS changes by an angle-based method☆

摘要: Objective: In acute myocardial ischemia changes within the QRS complex can add valuable information to that from repolarization phase. This study evaluates three angles obtained main slopes of R-wave assess ischemia. Methods: The angles, denoted by OR (R-wave angle), OU (up-stroke angle) and OD (downstroke were evaluated in 12-lead electrocardiogram (ECG) recordings 79 patients before during coronary occlusion elective percutaneous intervention (PCI). a subset 38 patients, was quantified scintigraphy. Results: At baseline presented low variations. During occlusion, developed fast abrupt change, whereas showed smaller gradual change. There significant correlations between both maximal sum positive change ischemia: r = 0.67; p b 0.001 0.78; 0.001, for extent, 0.60; 0.73; severity, respectively. Prediction extent severity increased 50% adding ST-segment changes, LCX occlusions, 12.1% 24.6% LAD RCA No correlation seen Conclusions: Evaluation standard ECG represents sensitive marker detection ischemia, whereas, be used prediction its severity.