Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.

Poor R Wave Progression 例における陳旧性前壁梗塞の鑑別―体表面心臓電位図による検討―

井原 敬子 岡山大学医学部第一内科学教室
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The clinical usefulness of the body surface maps (maps) to discriminate old anterior myocardial infarction (OAMI) in patients whose ECG showed poor R wave progression (PRWP) was examined. The maps of 60 patients with PRWP, including 33 cases of OAMI and 27 without myocardial infarction (non-MI) were recorded. The multivariate stepwise discriminant analysis elucidated that 5 leads (G4, C3, J5, B3, A5) of the QRST area map would contribute to the discrimination of OAMI from non-MI, and the the formula z=-6.0×G4+26.8×C3+9.1×J5-14.0×B3-9.0×A5-1.1(unit : 0.1mVS), using these parameters two groups were separated with a sensitivity of 90.9% and a specificity of 96.3%. The discriminating performance using 5 leads (G4, H2, H4, L6, M5)of the QRS area map and 5 leads (G5, G2, H4, L5, M5) of the Q20 map gave a sensitivity of 90.9%, and 93.9%, and specificity of 96.3%, and 92.6%, respectively. Furthermore, for formula was applied to 26 new consecutive patients with PRWP for evaluating this formula. The indicies obrained from the QRST area map gave the best results, and provided a sensitivity of 85.7% and a specificity of 100%. In the pattern of the QRST area map, the existence of the regions less than-20μVS can fairly identify the OAMI (sensitivity 87.9%, specificity 85.2%). These findings suggest that the mathematical models obtained from the result of map analysis, especially QRST area maps, are useful to discriminate OAMI among the cases with PRWP.
old myocardial infraction
body surface mapping
poor R wave progression