Department of Experimental and Clinical Cardiology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, France.
Ann Noninvasive Electrocardiol. 2022 Nov;27(6):e12994. doi: 10.1111/anec.12994. Epub 2022 Aug 19.
The T wave of the electrocardiogram (ECG) reflects ventricular repolarization. Repolarization heterogeneity is associated with reentrant arrhythmias. Several T-wave markers (including QT interval) have been associated with ventricular arrhythmias, but studies linking such markers to underlying local repolarization time (RT) inhomogeneities are lacking. We aimed to investigate the relation of several T-wave markers to controlled drug-induced regional RT gradients in intact pig hearts.
Repolarization time gradients were created by regional infusion of dofetilide and pinacidil in four atrially paced porcine Langendorff-perfused hearts placed inside a torso tank. From the 12-lead ECG on the torso tank, the mean, maximum, and dispersion (max-min) of QT , JT , T , T , TQ , dV/dt , T , T , and T-upslope duration were determined, as well as upslope end difference between leads V and V .
Temporal T-wave parameters T , T and TQ show a significant and high correlation with RT gradient, best reflected by mean value. T (mean, max and dispersion) and dV/dt dispersion show only a moderate significant correlation. T-upslope duration shows a significant correlation in particular for mean values. Mean, maximum, or dispersion of QT and V -V upslope end difference were not significantly correlated with RT gradient.
Composite 12-lead ECG T-wave parameters T , T , TQ , upslope duration, and T show a good correlation with underlying RT heterogeneity, whereas standard clinical metrics such as QT do not reflect local RT heterogeneity. The composite T-wave metrics may thus provide better insights in arrhythmia susceptibility than traditional QT metrics.
心电图（ECG）的 T 波反映心室复极。复极不均一与折返性心律失常有关。一些 T 波标志物（包括 QT 间期）与室性心律失常相关，但缺乏将这些标志物与潜在的局部复极时间（RT）异质性联系起来的研究。我们旨在研究几种 T 波标志物与完整猪心药物诱导的局部 RT 梯度的关系。
通过在放置在躯干罐内的四个心腔起搏的猪 Langendorff 灌流心脏中局部输注多非利特和匹那地尔来创建复极时间梯度。从躯干罐上的 12 导联心电图中，确定 QT、JT、T、T、TQ、dV/dt、T、T、T 和 T 斜率持续时间的平均值、最大值和离散度（最大值-最小值），以及导联 V 和 V 之间的斜率末端差异。
T 波时间参数 T、T 和 TQ 与 RT 梯度具有显著的高度相关性，以平均值最佳反映。T（平均值、最大值和离散度）和 dV/dt 离散度仅具有中度显著相关性。T 斜率持续时间特别是平均值具有显著相关性。QT 的平均值、最大值或离散度以及 V-V 斜率末端差异与 RT 梯度没有显著相关性。
12 导联心电图复合 T 波参数 T、T、TQ、斜率持续时间和 T 与潜在的 RT 异质性具有良好的相关性，而标准的临床指标如 QT 则不能反映局部 RT 异质性。与传统的 QT 指标相比，复合 T 波指标可能提供更好的心律失常易感性见解。
