Clinical Implication of the Presence of Notch Wave in ECG for Patients With Left Circumflex Artery-related Acute Myocardial Infarction / 中国循环杂志

ABSTRACT

Objectives: To evaluate the clinical implication of notch (N) Wave in ECG for patients with left circumflex artery-related acute myocardial infarction. Methods: A total of 416 patients with left circumflex artery-related acute myocardial infarction hospitalized in our hospital from January 2013 to December 2016 were included in this study. According to the electrocardiogram, 156 people were divided into ST segment elevation myocardial infarction group, 108 patients in N wave non-ST segment elevation myocardial infarction group, and 152 patients in non-N wave NSTEMI group. Troponin I and creatine kinase isoenzyme, hospitalization to operation time, vascular lesion site and degree, the intraoperative and postoperative complications were compared among the 3 groups. Results: Troponin I and creatine kinase isoenzyme levels were significantly lower in non-N wave NSTEMI group than in STEMI group and N wave NSTEMI group (P<0.05). The occurrence rate of no-reflow phenomenon was significantly higher in N wave NSTEMI group than in STEMI group and non N wave NSTEMI group (P<0.05). There was no significant difference in incidence of cardiac shock, ventricular fibrillation, ventricular aneurysm and death rate among the 3 groups(P>0.05). Incidence rate of lesion located in the proximal and middle section of left circumflex artery as well as the mean vascular stenosis degree were significantly lower, while incidence rate of lesion located in the distal section of left circumflex artery and obtuse marginal branches was significantly higher in non N wave NSTEMI group than in STEMI group and N wave NSTEMI group(P<0.05). Conclusions: Presence of Notch wave in ECG is associated with higher incidence of lesion located in the proximal and middle section of left circumflex artery, larger infarct size and higher incidence of no-reflow in patients with left circumflex artery-related acute myocardial infarction.