Mirvis D M
Am J Cardiol. 1982 Jul;50(1):122-8. doi: 10.1016/0002-9149(82)90017-0.
S-T segment elevation is commonly observed in the electrocardiogram of normal persons. To study the possible origins of such patterns, 45 normal volunteers were examined. Electrocardiographic potentials were registered from 150 torso electrodes and processed to construct isopotential maps at 2 ms intervals throughout the QRS-T interval. The maximal potentials recorded from any of the 150 electrodes were 198 +/- 76.4 and 272.1 +/- 84.2 microV at instants 40 and 80 ms into the S-T segment, respectively. Maximal voltages recorded by the six standard precordial V leads at these respective time points were 109.7 +/- 57.0 and 163.6 +/- 66.9 microV. Torso maximal potentials were significantly stronger than were those sensed by V leads; the two were significantly correlated but predictability was limited. The duration of overlap between the onset of ventricular recovery and the end of the excitation was determined from isopotential maps and ranged rom 4 to 16 ms. There was no significant correlation (p greater than 0.05) between these values and either torso or V lead potentials at either 40 or 80 ms into S-T segment. These data suggest that (1) standard precordial leads do not accurately predict maximal torso potentials during the S-T segment, and (2) the degree of overlap between repolarization and depolarization is not a major determinant of precordial voltage. Hence, the rationale for use of the term "early repolarization" to describe this clinical condition is not substantiated.
S-T段抬高常见于正常人的心电图中。为研究这种图形的可能起源，对45名正常志愿者进行了检查。从150个躯干电极记录心电图电位，并进行处理以在整个QRS-T间期以2毫秒的间隔构建等电位图。在S-T段开始后40毫秒和80毫秒时，从150个电极中的任何一个记录到的最大电位分别为198±76.4微伏和272.1±84.2微伏。在这些相应时间点，六个标准胸前V导联记录到的最大电压分别为109.7±57.0微伏和163.6±66.9微伏。躯干最大电位明显强于V导联所感知的电位；两者显著相关，但预测性有限。根据等电位图确定心室复极开始与兴奋结束之间的重叠持续时间为4至16毫秒。在S-T段开始后40毫秒或80毫秒时，这些值与躯干或V导联电位之间均无显著相关性（p＞0.05）。这些数据表明：（1）标准胸前导联不能准确预测S-T段期间的最大躯干电位；（2）复极化与去极化之间的重叠程度不是胸前电压的主要决定因素。因此，使用“早期复极化”一词来描述这种临床情况的理论依据不成立。
