McPherson D D, Horacek B M, Sutherland D J, Armstrong C S, Spencer C A, Montague T J
J Electrocardiol. 1985 Oct;18(4):351-60. doi: 10.1016/s0022-0736(85)80017-0.
To investigate the spectrum of change in multiple-lead exercise electrocardiograms, 120-lead body surface potential maps (BSPM) in normal adult subjects during upright, graded, submaximal exercise testing were recorded. Results showed that in the normal group, exercise was associated with substantial electrocardiographic changes on the body surface, many of which persisted during early recovery. The QRS waveform was minimally altered during exercise. Despite, however, no change in QRS duration, there was significant reduction in QRS potential range with consequent reduction QRS integral value. The ST waveforms changed markedly with exercise, showing abbreviated duration and increased slope. This was reflected by significantly increased ST potential range from rest to immediate cessation of exercise, which returned towards resting value during recovery. The effect of the altered ST-segment waveform was also reflected in torso potential distributions at two time instants during the ST-segment. When a spatially-fixed position on the ST-T waveform was evaluated (ST-segment offset), exercise resulted in small potential changes, especially over the torso area occupied by the standard V1 to V6 chest leads. However, when a temporally-fixed point (80 ms after QRS offset) was evaluated, there were large increases in potential over the precordium with exercise. Isointegral ST-segment maps, which reflect both spatial and temporal ST properties, showed that exercise was associated with substantial decreases in values over the precordium and inferior torso, and although diminished, they tended to persist through five minutes of recovery. Thus, electrocardiographic repolarization parameters are particularly affected by physiological exercise and, although the underlying causes of these changes remain undefined, they should be taken into account when evaluating the population at risk.
为研究多导联运动心电图的变化谱，记录了正常成年受试者在直立、分级、次极量运动试验期间的120导联体表电位图（BSPM）。结果显示，在正常组中，运动与体表显著的心电图变化相关，其中许多变化在早期恢复过程中持续存在。运动期间QRS波形态变化最小。然而，尽管QRS时限无变化，但QRS电位范围显著减小，导致QRS积分值降低。ST段波形随运动明显改变，表现为时限缩短和斜率增加。这表现为从静息到运动立即停止时ST段电位范围显著增加，恢复期间又回到静息值。ST段波形改变的影响也反映在ST段两个时刻的躯干电位分布上。当评估ST-T波形上空间固定的位置（ST段偏移）时，运动导致小的电位变化，特别是在标准V1至V6胸导联所占据的躯干区域。然而，当评估时间固定点（QRS波偏移后80毫秒）时，运动时胸前区电位大幅增加。反映ST段空间和时间特性的等积分ST段图显示，运动与胸前区和下躯干的值大幅降低相关，并且尽管有所减小，但它们在恢复的五分钟内仍倾向于持续存在。因此，心电图复极参数特别受生理运动的影响，尽管这些变化的潜在原因仍不明确，但在评估高危人群时应予以考虑。
