Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
PLoS One. 2013 Aug 13;8(8):e71876. doi: 10.1371/journal.pone.0071876. eCollection 2013.
Clinical studies have demonstrated the predictive values of changes in electrocardiographic (ECG) parameters for the preexisting myocardial ischemic infarction. However, a simple and early predictor for the subsequent development of myocardial infarction during the ischemic phase is of significant value for the identification of ischemic patients at high risk. The present study was undertaken by using non-human primate model of myocardial ischemic infarction to fulfill this gap. Twenty male Rhesus monkeys at age of 2-3 years old were subjected to left anterior descending artery ligation. This ligation was performed at varying position along the artery so that it produced varying sizes of myocardial infarction at the late stage. The ECG recording was undertaken before the surgical procedure, at 2 h after the ligation, and 8 weeks after the surgery for each animal. The correlation of the changes in the ECG waves in the early or the late stage with the myocardial infarction size was analyzed. The R wave depression and the QT shortening in the early ischemic stage were found to have an inverse correlation with the myocardial infarction size. At the late stage, the R wave depression, the QT prolongation, the QRS score, and the ST segment elevation were all closely correlated with the developed infarction size. The poor R wave progression was identified at both the early ischemic and the late infarction stages. Therefore, the present study using non-human primate model of myocardial ischemic infarction identified the decreases in the R wave and the QT interval as early predictors of myocardial infarction. Validation of these parameters in clinical studies would greatly help identifying patients with myocardial ischemia at high risk for the subsequent development of myocardial infarction.
临床研究已经证明心电图(ECG)参数变化对预先存在的心肌缺血性梗死具有预测价值。然而,在缺血期内,对于预测随后发生心肌梗死的简单且早期的指标,对于确定处于高风险的缺血患者具有重要意义。本研究通过使用非人灵长类动物心肌缺血性梗死模型来填补这一空白。将 20 只年龄在 2-3 岁的雄性恒河猴进行左前降支结扎。结扎手术在动脉的不同位置进行,以在晚期产生不同大小的心肌梗死。在手术前、结扎后 2 小时和手术后 8 周,对每只动物进行心电图记录。分析心电图波在早期或晚期变化与心肌梗死大小的相关性。在早期缺血阶段,R 波压低和 QT 缩短与心肌梗死大小呈负相关。在晚期,R 波压低、QT 延长、QRS 评分和 ST 段抬高均与发展的梗死大小密切相关。在早期缺血和晚期梗死阶段均发现 R 波进展不良。因此,本研究使用非人灵长类动物心肌缺血性梗死模型,确定 R 波和 QT 间期的降低是心肌梗死的早期预测指标。在临床研究中验证这些参数将极大地帮助识别具有高风险发生心肌缺血后发展为心肌梗死的患者。