Nagasaka M, Hayashi H, Hirai M, Ichihara Y, Takahama S, Kondo K, Saito H
First Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Am Heart J. 1991 Mar;121(3 Pt 1):763-9. doi: 10.1016/0002-8703(91)90186-l.
The possibility of detecting myocardial infarction (MI) in the presence of Wolff-Parkinson-White (WPW) syndrome by means of body surface QRST isoarea maps was studied in eight dogs. Eighty-seven body surface ECGs were recorded simultaneously. Recordings were taken during right atrial (RA) and right atrial and right ventricular (RA + RV) sequential pacing, which simulated WPW syndrome, during control periods and at 1-hour intervals for up to 5 hours after occlusion of the left anterior descending coronary artery. In ECGs during the RA drive, diagnostic findings of MI such as abnormal Q waves were observed but became obscure during the RA + RV drive. On the contrary, the QRST values over the anterior chest during both drives were positive soon after coronary occlusion, decreased gradually as time passed, and became abnormally negative after 5 hours. The QRST isoarea maps during RA and RA + RV pacing showed quite similar patterns and were highly correlated with each other throughout this study (r greater than 0.95). These findings demonstrate that localized abnormalities resulting from MI are evident in QRST isoarea maps even in the presence of preexcitation and fusion.
在八只犬中研究了利用体表QRST等面积图在存在预激综合征（WPW）的情况下检测心肌梗死（MI）的可能性。同时记录了87份体表心电图。在模拟WPW综合征的右心房（RA）起搏以及右心房和右心室（RA + RV）顺序起搏期间、对照期以及在左前降支冠状动脉闭塞后长达5小时内每隔1小时进行记录。在RA驱动期间的心电图中，观察到了MI的诊断性表现，如异常Q波，但在RA + RV驱动期间变得模糊不清。相反，在两次驱动期间，冠状动脉闭塞后不久前胸的QRST值为正，随着时间推移逐渐降低，5小时后变为异常负值。在RA和RA + RV起搏期间的QRST等面积图显示出非常相似的模式，并且在整个研究过程中彼此高度相关（r大于0.95）。这些发现表明，即使存在预激和融合，MI导致的局部异常在QRST等面积图中也是明显的。
