Three-dimensional distribution of ST-T wave alternans during acute ischemia.
Three-dimensional distribution of ST-T wave alternans during acute ischemia.
复制标题
急性缺血时 ST-T 波交替的三维分布。
DOI：
10.1111/j.1540-8167.1997.tb01038.x
复制
发表时间：
1997
影响因子：
2.7
通讯作者：
Lux,RL
中科院分区：
文献类型：
--
作者：
Green,LS;Fuller,MP;Lux,RL
前言：采用犬冠状动脉可逆性缺血模型，测量复极交替的大小和跨壁分布。方法和结果：将24个多电极针插入冠状动脉闭塞8分钟后形成的可逆性缺血区。每隔1分钟同时记录192个单极心电图，分别记录缺血8分钟和复流恢复3分钟。使用QRST积分的标准差对所有心电图的搏动到搏动的复极交替进行量化。当将来自纤颤动物的交替信号与来自非纤颤动物的交替信号进行比较时，纤颤组的交替信号的幅度在发生纤颤时的平均标准差为1125±99.7 mV-msec，而在未发生纤颤的动物中，在缺血8分钟时的平均标准差为409±183 mV-msec。在纤颤的动物中，交替的增加主要发生在心肌中部和心外膜区域。连续心电图QRS形态在逐搏比较中无差异，提示所测复极交替不是由于可逆性缺血区的交变传导阻滞所致。结论：急性缺血时，复极交替的幅度和分布在发生室颤的心脏中较大，且不同。这一观察结果可能对心律失常的预测有临床价值。这也与复极交替可能存在多种机制的可能性相一致。
Repolarization Alternans in Ischemia.Introduction: A canine model of reversible ischemia was used to measure the magnitude and transmural distribution of repolarization alternans.Methods and Results: Twenty‐four multielectrode needles were inserted into a reversibly ischemic region created by 8 minutes of coronary occlusion. One hundred ninety‐two unipolar electrograms were simultaneously recorded at 1‐minute intervals for 8 minutes of ischemia and 3 minutes of reflow recovery. Beat‐to‐beat repolarization alternans was quantified for all electrograms using the standard deviation of QRST integrals. When alternans from animals that fibrillated was compared with alternans from animals that did not, the magnitude of alternans in the fibrillation group was an average standard deviation of 1125 ± 99.7 mV‐msec at the time of fibrillation and 409 ± 183 mV‐msec at 8 minutes of ischemia in the animals that did not fibrillate. The increase in alternans occurred mainly in the mid‐myocardial and epicardial regions in the animals that fibrillated. QRS morphology of sequential electrograms did not differ in beat‐to‐beat comparison, suggesting that repolarization alternans measured was not due to alternating conduction block in the region of reversible ischemia.Conclusion: During acute ischemia, the magnitude and distribution of repolarization alternans are greater and differ in hearts that experience ventricular fibrillation. This observation may have clinical utility in arrhythmia prediction. It also is consistent with the possibility there may be multiple mechanisms for repolarization alternans.