Kootsey J M, Johnson E A
Crit Rev Bioeng. 1980;4(3):233-70.
Of all the features of the electrocardiogram, the T wave shows the earliest and most dramatic correlation with abnormalities of electrical behavior in the heart. Yet, it has remained difficult to make quantitative connections between the T wave and electrical activity in the heart at the cellular level. It is the purpose of this paper to review attempts at deriving T waves from a knowledge of the membrane electrical activity in the heart and the geometry and conductive properties of the heart and its surrounding medium. We first summarize the problem of calculating T-wave potentials on the body surface, based on physical laws. Next, we review the empirical conclusions that have been reached through observations of the T wave, including its connection with repolarization of the cell membrane, the distributed nature of the current source during the T wave, and the gradient in action potential duration responsible for the positive polarity of the normal T wave. Six quantitative models have been proposed for the T wave; we compare these models and comment on their accuracy and underlying assumptions. Finally, we discuss ideas that have been suggested for the membrane mechanism of repolarization and the T wave.
在心电图的所有特征中，T波与心脏电活动异常的相关性出现得最早且最为显著。然而，在细胞水平上，要在T波与心脏电活动之间建立定量联系仍然很困难。本文旨在回顾基于心脏膜电活动、心脏及其周围介质的几何形状和传导特性来推导T波的尝试。我们首先根据物理定律总结体表T波电位的计算问题。接下来，我们回顾通过对T波的观察得出的经验性结论，包括其与细胞膜复极化的关系、T波期间电流源的分布性质以及导致正常T波正极性的动作电位持续时间梯度。已经提出了六种T波的定量模型；我们比较这些模型，并对其准确性和基本假设进行评论。最后，我们讨论关于复极化和T波的膜机制所提出的观点。
