The relation between changes in electrocardiogram and infarction related artery in patients with acute inferior myocardial infarction

Objective To predict the culprit artery in acute inferior myocardial infarction by assessing the relevant ST segment deviation of different leads. Methods The features of electrocardiograms in different leads was analyzed in three groups patients divided according to the infarction related artery (IRA) documented by coronary arteriography. Results (1)The incidence of ST segment elevation in lead Ⅲ higher than in lead Ⅱ was higher in right coronary artery (RCA) group than in left circumflex artery (LCX) and RCA+LCX groups ( P 0 005),and had a better sensitivity (Se),specificity (Sp),efficiency (e ),positive predictive value (PPV) and negative predictive value (NPV) in predicting RCA obstruction.The incidence of ST segment elevation in V 7～V 9 lead was higher in LCX and RCA+LCX groups than in RCA group ( P 0 005),the incidence of ST segment elevation in V 3R ～V 5R lead was higher in RCA and RCA+LCX groups than in LCX group ( P 0 005),both of the above mentioned indexes had better Se and NPV in predicting IRA;(2)The incidence of ST segment depression in lead Ⅰ and aVL and deeper ST segment depression in lead aVL than in lead I were higher in RCA and RCA+LCX group than in LCX groups ( p 0.005～0.05),The incidence of ST segment depression in lead V 1～V 6 were higher in LCX and RCA+LCX group than in RCA groups ( P 0 005～0 05). Conclusion A higher ST segment elevation in lead Ⅲ than in lead Ⅱ、a deeper ST segment depression in lead aVL than in lead Ⅰ、ST segment elevation in V 7～V 9 lead、ST segment elevation in V 3R ～V 5R lead、ST segment depression in lead V 1～V 6 are sensitivity and specificity markers for predicting IRA in this group of inferior wall acute myocardial infarction.