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,在急性心肌缺血期间,在13只猪的40分钟冠状动脉球囊扩张产生的心肌梗塞实验模型中,评估了与心室去极化和复极化同时对应的几个心电图(ECG)衍生指标。从开始进行冠状动脉闭塞后的第4分钟开始迅速观察到显着变化,分别在去极化的11至22分钟和重新极化的9至12分钟之间达到最大值。随后,在咬合的后期,这些最大变化开始减少。与QRS波复杂度的后半部分相关的去极化变化与闪烁显像图像估计的危险心肌(MaR)呈显着但呈负相关。在咬合期间观察到的两个更相关的峰处评估的MaR与QRS络合物的向下斜率变化之间的相关性为[r = -0.75,p <0.01和r = -0.79,p分别在[公式:参见文本],时间演变中观察到的正挠度和负挠度<0.01。通过在主要观察到的正峰值处评估ST段抬高来分析的复极变化也显示为负,但与MaR的相关性不显着:r = -0.34,p = 0.28。我们的结果表明,在去极化后期评估的变化(如[公式:请参见文本]所述)受R波幅度,QRS宽度和ST水平变化的同时影响,与缺血量的相关性更好。比在去极化早期或ST段评估的其他指数要高。

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