Bergfeldt Lennart, Gransberg Lennart, Lundahl Gunilla
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Heart Rhythm O2. 2025 Feb 17;6(5):709-719. doi: 10.1016/j.hroo.2025.02.005. eCollection 2025 May.
Changes in dispersion of ventricular repolarization is a salient electrophysiological feature of acute myocardial ischemia and linked to life-threatening arrhythmias. In 9 studies, we applied Frank vectorcardiography not only for noninvasive monitoring of cardiac electrophysiology during acute ischemia induced during percutaneous coronary interventions, during clinical myocardial infarction, and in an occlusion-reperfusion pig model, but also for prognostic purposes after coronary events. Myocardial ischemia was in humans and pigs associated with significant changes in the ST segment, Tamplitude, Tarea, ventricular gradient, and T vector loop morphology. In the pig model, a link between dispersion changes and the occurrence and suppression (by spinal cord stimulation) of ventricular arrhythmias was found. Prognostically, after recent acute coronary events, the spatial peak and mean QRS-T angles were superior. In summary, vectorcardiography-based parameters were validated as reflecting changes in repolarization dispersion during myocardial ischemia in humans and pigs, and in pigs linked to the occurrence and suppression of ventricular arrhythmias.
心室复极离散度的改变是急性心肌缺血的一个显著电生理特征，且与危及生命的心律失常有关。在9项研究中，我们应用弗兰克向量心电图不仅用于在经皮冠状动脉介入治疗期间、临床心肌梗死期间以及闭塞-再灌注猪模型中诱导的急性缺血期间对心脏电生理进行无创监测，还用于冠状动脉事件后的预后评估。在人类和猪中，心肌缺血与ST段、T波振幅、T波面积、心室梯度和T向量环形态的显著变化相关。在猪模型中，发现离散度变化与室性心律失常的发生及（通过脊髓刺激）抑制之间存在联系。在预后方面，近期急性冠状动脉事件后，空间峰值和平均QRS-T角更具优势。总之，基于向量心电图的参数被证实可反映人类和猪心肌缺血期间复极离散度的变化，并且在猪中与室性心律失常的发生及抑制有关。
