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急性冠状动脉结扎诱导的离体兔心脏心电图QRS波变化。

Electrocardiographic QRS changes induced by acute coronary ligation in the isolated rabbit heart.

作者信息

Mirvis D M

出版信息

J Electrocardiol. 1979;12(2):141-50. doi: 10.1016/s0022-0736(79)80022-9.

Abstract

The electrical fields associated with augmented R- and decreased S-wave amplitudes during acute, severe myocardial ischemia were studied in fifteen isolated rabbit heart preparations. Hearts were suspended in a spherical tank and perfused with oxygenated electrolyte solution. Electrocardiographic signals were recorded from electrodes on the tank's surface and processed by computerized methods. Fifteen minutes after suture ligation of the left anterior descending coronary artery, records from electrodes overlying the lesion demonstrated increased R-wave amplitude and ST-segment elevation. Fitting a single moving dipole to pre- and post-ligation potentials demonstrated that the ligation increased the dipolarity of the field and shifted the terminal QRS dipole to a position topographically related to the location of the ischemic lesion. The effects of injury were further assessed by study of fields computed by subtracting control from post-ligation data. This generated a dipolar field at the instant of maximal dipole moment whose strength directly correlated (r=0.74) with the area of non-perfused epicardium, as determined by post-ligation methylene blue infusion. These results suggest that the electrical fields generated during mid to late dipolarization by coronary ligation are qualitatively similar to those generated during repolarization, and may therefore be of similar clinical and/or experimental value.

摘要

在15个离体兔心标本中,研究了急性重度心肌缺血期间与R波增高和S波降低相关的电场。心脏悬浮于球形槽中,并用含氧电解质溶液灌注。从槽表面的电极记录心电图信号,并通过计算机方法进行处理。在左前降支冠状动脉缝合结扎15分钟后,病变上方电极的记录显示R波振幅增加和ST段抬高。用单个移动偶极拟合结扎前后的电位表明,结扎增加了电场的偶极性,并将终末QRS偶极移至与缺血病变位置在地形上相关的位置。通过研究从结扎后数据中减去对照计算得到的电场,进一步评估损伤的影响。这在最大偶极矩瞬间产生了一个偶极场,其强度与结扎后注入亚甲蓝所确定的未灌注心外膜面积直接相关(r=0.74)。这些结果表明,冠状动脉结扎在中期至晚期去极化期间产生的电场在性质上与复极化期间产生的电场相似,因此可能具有相似的临床和/或实验价值。

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