左心室肥厚中的电重构和结构重构——QRS波电压降低的一个基础？
Electrical and structural remodeling in left ventricular hypertrophy-a substrate for a decrease in QRS voltage?
作者信息
Bacharova Ljuba
机构信息
The International Laser Center, Bratislava, Slovak Republic.
出版信息
Ann Noninvasive Electrocardiol. 2007 Jul;12(3):260-73. doi: 10.1111/j.1542-474X.2007.00170.x.
Abstract
Electrical remodeling in advanced stages of cardiovascular diseases creates a substrate for triggering and maintenance of arrhythmias. The electrical remodeling is a continuous process initiated already in the early stages of cardiological pathology. The aim of this opinion article was to discuss the changes in electrical properties of myocardium in left ventricular hypertrophy (LVH), with special focus on its early stage, as well as their possible reflection in the QRS amplitude of the electrocardiogram. It critically appraises the classical hypothesis related to the QRS voltage changes in LVH. The hypothesis of the relative voltage deficit is discussed in the context of supporting evidence from clinical studies, animal experiments, and simulation studies. The underlying determinants of electrical impulse propagation which may explain discrepancies between "normal" ECG findings and increased left ventricular size/mass in LVH are reviewed.
摘要
心血管疾病晚期的电重构为心律失常的触发和维持创造了条件。电重构是一个在心脏病理学早期就已启动的持续过程。这篇观点文章的目的是讨论左心室肥厚（LVH）中心肌电特性的变化，特别关注其早期阶段，以及这些变化在心电图QRS波幅中的可能反映。文章批判性地评估了与LVH中QRS电压变化相关的经典假说。在临床研究、动物实验和模拟研究的支持证据背景下，讨论了相对电压不足的假说。回顾了可能解释“正常”心电图表现与LVH中左心室大小/质量增加之间差异的电冲动传播的潜在决定因素。
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