The effect of reduced intercellular coupling on electrocardiographic signs of left ventricular hypertrophy
The effect of reduced intercellular coupling on electrocardiographic signs of left ventricular hypertrophy
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DOI：
10.1016/j.jelectrocard.2011.06.004
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发表时间：
2011-09-01
影响因子：
1.3
通讯作者：
Potse, Mark
中科院分区：
文献类型：
--
作者：
Bacharova, Ljuba;Mateasik, Anton;Potse, Mark
背景：左心室肥厚 (LVH) 的心电图 (ECG) 诊断基于 QRS 电压随左心室质量增加的假设。然而，大多数超声心动图检测到 LVH 的患者并没有出现 QRS 电压升高。在 LVH 患者和动物模型中观察到细胞间耦合减少。本研究的目的是证明这种解耦可以解释 LVH 患者中相对较低的 QRS 电压。方法：使用人类心脏和躯干的真实大型计算机模型模拟心电图和心向量图 (VCG)，可靠地代表减少耦合对传播和心电图电压的影响。结果：除 aVL 之外的所有导联中解耦降低的 QRS 电压，反映矢量幅度的减小以及表明左前轴的左偏结论：低 QRS 电压并不一定与 LVH 的诊断相矛盾，但可能是电解偶联的指征。这种“相对电压不足”的诊断价值需要在临床研究中得到证明。 (C) 2011 Elsevier Inc. 保留所有权利。
Background: The electrocardiographic (ECG) diagnosis of left ventricular hypertrophy (LVH) is based on the assumption that QRS voltage increases with left ventricular mass. However, most of patients with echocardiographically detected LVH do not have increased QRS voltage. Reduced intercellular coupling has been observed in LVH patients and animal models. The purpose of this study was to show that this uncoupling can explain relatively low QRS voltage in LVH patients.Methods: Electrocardiograms and vectorcardiograms (VCG) were simulated with a realistic large-scale computer model of the human heart and torso that reliably represented the effects of reduced coupling on both propagation and ECG voltage.Results: Uncoupling reduced QRS voltage in all leads except aVL, reflecting a decrease in vector amplitude as well as a leftward axis deviation that suggested left anterior fascicular block.Conclusions: Low QRS voltage does not necessarily contradict a diagnosis of LVH but may be an indication for electrical uncoupling. The diagnostic value of this "relative voltage deficit" needs to be demonstrated in clinical studies. (C) 2011 Elsevier Inc. All rights reserved.