Comparative Analysis Between Resting ECG And Coronary Angiography In Patients With Coronary Heart Disease

Background and Purpose: ECG is an important patient clinical data,since it is not only simple,convenient,cost-effective,but also non-invasive,making it widely used in clinical practice.It not only allows doctors to screen high-risk patients quickly,but also help clinicians make the right treatment.As we all know,coronary angiography is the gold standard means examination of coronary heart disease,we will compare the electrocardiogram with coronary angiography,there are false positive rate and false negative rate in the ECG,so comparative analysis of ECG findings and coronary angiography results,summarized the related laws between different vascular lesions,varying degrees of stenosis and ECG,and it has a significance in further improving the rate of correct diagnosis of coronary artery disease.This paper focus on the findings of ECG and coronary angiography results,and obtaining the ECG information about the lesion location and some closely related information,reaching the result about the coronary lesions associated conditions from the ECG as much as possible.Methods:Qingdao Municipal Hospital Heart Center inpatient treatment of patients with coronary heart disease in 2015 were selected,and angiography showed vascular disease was only a single place(the number of involved coronary vascular is 1,LAD or RCA or LCX,and the degree of stenosis is 50% or more,including AMI,Angina),a total of 191 cases,Myocardial infarction group 70 cases,non-Myocardial infarction group 121 cases,70 cases were male and 79 females,mean 60.2 ± 12.5 years.According to a narrow position,divided into anterior descending artery group(n = 83),right coronary artery group(n = 62),left circumflex artery group(n = 46);vascular lesions were categorized by visual inspection as mild stenosis(50 ≤ stenosis <70%),moderate stenosis(70≤ stenosis <90%)and severe stenosis(≥90%).All patients had a detailed history records,and ECG,coronary angiography,other laboratorial index.Patient inclusion criteria: patients with coronary heart disease,coronary angiography showed coronary arteries was a single-vessel disease LAD or RCA or LCX,and vascular stenosis≥50%,including AMI,Angina.Exclusion criteria: patients with a vascular disease or more,Cardiomyopathy,Valvular disease,patients with left main disease,patients with pacemaker implantation,bundle branch blocked patients,high blood pressure resulting in myocardial hypertrophy,patients with old myocardial infarction.pulmonary embolism.Each group of ECG results were analyzed,summarized ECG findings about different vascular lesions and various degree of stenosis,and analyzing the correlation between the degree of stenosis and ECG;observing II,Ⅲ,V3 ST-segment elevation or reduction,comparing indicator of STⅢ / STII,STV3 / STⅢ,indentifying LCX and RCA,and analyzing the positive predictive value of two indicators;observing av R,II,Ⅲ,avF lead ST changes,identification the LAD proximal or Cosco,and analyzing the positive predictive value.The date of this retrospective study,using SPSS 17.0,the measurement data were expressed by X ± s,variance analysis was used to analyze the differences among the groups,and the count data were expressed by percentage,between the groups were compared using the χ2 test was used to analyze the differences among the groups,P <0.05 was considered statistically significant.Results:(1)With the increase of the degree of stenosis,the sensitivity rates in line with were 31.8%,61%,90%,and the ECG sensitivity rate is gradually increased,the false negative rate 68.2%,39%,10%,ECG false negative rate gradually reduced;(2)If Ⅲ lead ST-segment elevation extent is greater than II lead,the ratio of V3 lead ST depression extent and Ⅲ lead ST elevation extent was less than 1.2,the criminal infarction artery was RCA probably,and the difference was significance(P <0.05);Without the above performance,possibility of infarct-related artery was LCX;(3)When anterior myocardial infarction,accompanied by the Ⅱ,Ⅲ,avF ST-segment depression,av R ST-segment elevation,these were useful to judge the closing position in the proximal LAD,without the above performance,possibility of infarct-related artery was Cosco LAD,and these were statistically significant(P <0.05).Conclusions:(1)Comparison analysis between different degrees of coronary stenosis and ECG,with the degree of stenosis increasing,ECG false negative rate was gradually reduced and the sensitivity rate was gradually increased;(2)Identifying inferior wall infarction,whether caused by RCA or LCX,the ratio of ST_Ⅱ,ST_Ⅲ elevation extent,the ratio of V3 lead ST depression extent and Ⅲ lead ST elevation may assist to judge the infarction position;(3)Identifying anterior infarction,whether caused by proximal or Cosco LAD,whether ST_Ⅱ,ST_Ⅲ,STavF were depressed and whether STav R was elevated may assist to judge the infarction position.