Mirvis D M, Ingram L A, Ramanathan K B, Wilson J L
J Am Coll Cardiol. 1986 Sep;8(3):675-81. doi: 10.1016/s0735-1097(86)80200-5.
Electrocardiographic R and S wave changes occur after transmural myocardial infarction. It was the purpose of this study to define the spatial characteristics of these changes and their pathologic determinants after nontransmural as well as transmural necrosis. Twenty-six dogs were studied after occlusion of the left circumflex coronary artery for 60 to 240 minutes, followed by reperfusion. Electrocardiographic potentials were recorded before and 1 week after infarction using an 84 electrode array to compute maximal and root-mean-square R and S wave voltages. Infarct size was quantitated by computer-aided evaluation of heart slices stained by triphenyltetrazolium chloride. R and S wave amplitudes after infarction varied widely from one torso site to another in a pattern generally consistent with the inferoposterior location of the infarcted zones. Although changes in peak R and S wave potentials did not significantly correlate with infarct size, differences in pre- and postocclusion root-mean-square R and S wave amplitudes did, with correlation coefficients of -0.79 and -0.63, respectively. Root-mean-square values increased for small lesions and decreased for larger ones. These data indicate that nontransmural as well as transmural infarction can produce R and S wave changes that are dependent on overall lesion size and the specific lead studied. Such changes may represent useful methods to quantitate lesion size.
透壁性心肌梗死后会出现心电图R波和S波改变。本研究的目的是明确非透壁性以及透壁性心肌坏死后这些改变的空间特征及其病理决定因素。对26只犬进行研究，结扎左旋冠状动脉60至240分钟后再灌注。在梗死前及梗死后1周记录心电图电位，使用84电极阵列计算R波和S波的最大电压及均方根电压。通过计算机辅助评估氯化三苯基四氮唑染色的心脏切片来定量梗死面积。梗死后R波和S波振幅在不同躯干部位差异很大，其模式通常与梗死区域的下后壁位置一致。尽管R波和S波峰值电位的变化与梗死面积无显著相关性，但闭塞前后R波和S波均方根振幅的差异与梗死面积相关，相关系数分别为-0.79和-0.63。小病灶的均方根值增加，大病灶的均方根值降低。这些数据表明，非透壁性和透壁性梗死均可产生依赖于整体病灶大小及所研究特定导联的R波和S波改变。此类改变可能是定量病灶大小的有用方法。
