Prognostic Value Of ST Segment Elevation Pattern In Acute Inferior Myocardial Infarction Patients With Or Without Acute Right Ventricular Infarction

Objective：To discuss the prognosis value of the different ST segment elevationpattern,205pieces of clinical data of acute inferior myocardial infarctionpatients with or without right ventricular infarction were retrospectivelyanalyzed.Methods：This research contained205cases from the Department ofCardiovascular Disease of The First Bethune Hospital of Jilin Universityfrom January2013to October2014. The205patients (male:138,famale:67) were diagnosed as acute inferior myocardial infarction withor without right ventricle infarction, and treated with PCI (PercutaneousCoronary Intervention) in12hours since onset. The shapes of STsegment elevation was divided in three groups: concave type（n=64）,straight type（n=87） and convex type（n=54）, and each group’s clinicaldata were collected. The data were analyzed with SPSS19.0. Themeasurement data that obey normal distribution were present with mean±standard deviation and Chi-square test was used to compare theenumeration data, t-test was used to compare two mean data, ANOVA(Analysis of Variance) was applied among several groups;multivariate logistic regression analysis was applied to related riskfactors. The test statistical significance was set as P<0.05.Results：1. Baseline information: three groups of patients present nonestatistical significance among age, sex, smoke history, diabetes historyand hypertension history (P>0.05).2. Three groups patients present statistical significance in cTnI peakvalue and LVEF level (P<0.05). Comparing ST segment crescentelevation group with arch elevation group, statistical significance ispresented among pre-infarction angina, hypotension when admitted(<90/60mmHg), bradycardia, ventricle tachycardia, infarction relatedartery occlusion and abnormal Q waves (P<0.05). The hospital mortalityin three groups are2%,5%and7%, respectively. There are differences ofmortality in three groups, but none statistical significance is presented(P>0.05).3. In patients with acute inferior wall myocardial infarction,hypotension when admitted, bradycardia, ventricular tachycardia, cTnIpeak value and LVEF level exist statistical significance between thepatients with right ventricle infarction and without (P<0.05), whilepre-infarction angina, infarction related artery occlusion, abnormal Qwaves and hospital mortality show no statistical significance (P>0.05). 4. Statistical significance exists between the shapes of three groupsand the number of lesion vessel, as well as in three groups (P<0.05).5. ST segment crescent elevation is the independent correlationfactor of LVEF>50%(OR=9.897538, P<0.05).Conclusion：1. In acute inferior wall myocardial infarction patients with orwithout right ventricle infarction,concave type of ST segment elevationshows best prognosis, straight type middle and convex type worse;2. In acute inferior myocardial infarction patients, those whocombine with right ventricle infarction have a higher incidence rate ofarrhythmia and a poorer prognosis;3. concave type of ST segment elevation is the independentcorrelation factor of LVEF>50%;4. concave type of ST segment elevation group has a higherincidence rate of single leision vessel than other two groups, whileconvex type has a higher incidence rate of three leision vessels than othertwo groups.