In this study, several electrocardiogram (ECG)-derived indices corresponding to both ventricular depolarization and repolarization were evaluated during acute myocardial ischemia in an experimental model of myocardial infarction produced by 40 min coronary balloon inflation in 13 pigs. Significant changes were rapidly observed from minute 4 after the start of coronary occlusion, achieving their maximum values between 11 and 22 min for depolarization and between 9 and 12 min for repolarization indices, respectively. Subsequently, these maximum changes started to decrease during the latter part of the occlusion. Depolarization changes associated with the second half of the QRS complex showed a significant but inverse correlation with the myocardium at risk (MaR) estimated by scintigraphic images. The correlation between MaR and changes of the downward slope of the QRS complex, [Formula: see text], evaluated at the two more relevant peaks observed during the occlusion, was r = -0.75, p < 0.01 and r = -0.79, p < 0.01 for the positive and negative deflections observed in [Formula: see text], temporal evolution, respectively. Repolarization changes, analyzed by evaluation of ST segment elevation at the main observed positive peak, also showed negative, however non-significant correlation with MaR: r = -0.34, p = 0.28. Our results suggest that changes evaluated in the latter part of the depolarization, such as those described by [Formula: see text], which are influenced by R-wave amplitude, QRS width and ST level variations simultaneously, correlate better with the amount of ischemia than other indices evaluated in the earlier part of depolarization or during the ST segment.

译文

在这项研究中,在13头猪的40分钟冠状动脉球囊充气产生的心肌梗死实验模型中,评估了急性心肌缺血期间对应于心室去极化和复极化的几种心电图 (ECG) 衍生指标。从冠状动脉闭塞开始后的第4分钟开始迅速观察到显着变化,分别在去极化11至22分钟和复极化指数9至12分钟之间达到最大值。随后,在闭塞的后期,这些最大变化开始减少。与QRS复合物的后半部分相关的去极化变化与闪烁显像估计的危险心肌 (MaR) 呈显着但呈负相关。在闭塞期间观察到的两个更相关的峰处评估的MaR与QRS复合体向下斜率的变化之间的相关性为r = -0.75,p <0.01和r = -0.79,对于在 [公式: 参见文本] 中观察到的正偏转和负偏转,分别为p <0.01。通过评估主要观察到的正峰处的ST段抬高来分析复极化变化,也显示出负的,但与MaR无关: r = -0.34,p = 0.28。我们的结果表明,在去极化的后半部分评估的变化,例如 [公式: 参见文本] 所描述的变化,同时受到R波振幅,QRS宽度和ST电平变化的影响,与在去极化早期或ST段期间评估的其他指标相比,与缺血量的相关性更好。

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