Title: Sgarbossa Criteria

题目：Sgarbossa 标准（通过左束枝传导阻滞诊断急性心肌梗死）

Author 作者: Dan Lemkin

Sgarbossa et al, initially identified patients with MI and left bunde branch block (LBBB) from the GUSTO trial; these ECGs were compared to the ECGs of patients with chronic CAD and LBBB

Sgarbossa等人首先在GUSTO临床研究中确定了那些有心梗和左束枝传导阻滞（LBBB）的病人，他们的心电图和具有慢性冠心病和LBBB的病人的心电图进行了比较

LBBB is defined by 3 criteria QRS >125msec, V1- QS or rS, and R wave peak time 60ms with no q wave in leads I, V5, V6

LBBB的3个诊断标准为：QRS>125 毫秒，V1导联呈QS或rS，和R波高峰时间超过60毫秒并且在I，V5，V6导联没有q波。

After a criteria to identify MI with LBBB was estabilshed it was tested on patients presenting with chest pain and LBBB

在确定诊断有LBBB心电图表现的急性心肌梗死的标准后，将此标准在具有LBBB的心绞痛病人中进行了临床实践。

The study resulted in Sgarbossa criteria; 3

independent predictors of MI in setting of LBBB

Sgarbossa标准由此产生：既3个相互独立的通过LBBB的特征来诊断急性心肌梗塞

1.) ST segment concordance of 1mm any lead (greatest odd ratio, i.e. most specific)

1）在如何导联里，同向ST段抬高超过1mm（比值比最高，既最特异）

2.) ST depression 1mm V1- V3

2）V1－V3 ST段降低超过1mm

3.) Excessive ST discordance greater than 5mm (lowest odds ratio)

3）多导联相反方向的ST抬高或降低超过5mm （比值比最低，相关性较低）

References 参考文献

Sgarbossa E, et al. ELECTROCARDIOGRAPHIC DIAGNOSIS OF EVOLVING ACUTE MYOCARDIAL INFARCTION IN THE PRESENCE OF LEFT BUNDLE-BRANCH BLOCK. NEJM Feb 22, 1996: Vol 334; No. 8

References

Atrial Fibrillation. Bontempo L, Goralnick E. Emerg Med Clin N Am 29 (2011)747-758.