Value Of The Slectrocardiogram In Lead I And AvL ST Elevation For Acute Myocardial Infarction Related Arteries (IRA)

ObjectiveTo analyze the diagnostic value of ECG lead I and av L ST elevation in coronary arteries(IRA)associated with acute myocardial infarction.MethodsA retrospective analysis was used to collect the data of 127 patients with acute myocardial infarction(AMI)in the Department of Cardiology,Chaoyang Second Hospital in January 2018 and September 2019.All patients underwent electrocardiogram and coronary angiography(CAG)examinations.CAG results are used as the gold standard to analyze the accuracy of ST-segment elevation in leads I and a VL to predict the accuracy of IRA,draw receiver operating characteristic(ROC)curves,and evaluate the effects of ST-segment elevation in leads I and a VL on IRA Diagnostic value.Results1.The sensitivity of ST segment elevation of leads I and a VL to predict LAD proximal involvement was 30.65%(19/62),specificity was 93.85%(61/65),and accuracy was 62.99%(80/127).The sensitivity of ST segment elevation of leads I and a VL to predict LCX proximal involvement is 29.58%(21/71),specificity is91.09%(51/56),and accuracy is 56.69%(72/127).2.OMI lumen diameter of true positive patients with proximal LAD involvement is significantly smaller than false positive [(0.82 ± 0.19)vs(1.59 ±0.33)mm],and the distance from the OM1 emission point to the left trunk is significantly larger than the false positive [(9.32 ± 0.96)vs(5.27 ± 0.65)mm],the diameter of DI lumen in true positive LCX patients is significantly smaller than that in false positive patients [(1.16 ± 0.23)vs(2.09 ± 0.42)mm],and the distance from the point of D1 emission to the left trunk is significantly larger than that in false positive patients [(6.21 ± 1.05)vs(2.62 ± 0.43)mm],the differences were statistically significant(P<0.05).3.The ROC curve was established.The AUC value of ST-segment elevation in leads I and a VL predicted proximal LAD was 0.628(95%CI=0.471～0.665).When the cut-off value was 0.05 m V,the positive predictive value was 28.36% and the negative predictive value was 92.74%..I.ST-segment elevation in lead a VL predicts the proximal LCX AUC value is0.581(95%CI=0.493～0.680).When the cutoff value is 0.05 m V,the positive predictive value is 26.51% and the negative predictive value is 91.42%.Conclusions1.The ST-segment elevation in leads I and a VL of ECG has certain diagnostic value in the early diagnosis of IRA.2.ST segment elevation in leads I and a VL of AMI patients indicates that the blood vessel of the criminal may be located at the proximal end of LAD and LCX,and CAG examination can be used for further confirmation;3.In patients with AMI,if the ST segment in leads I and a VL is not elevated,it can be basically confirmed that the proximal ends of LAD and LCX have no disease.