Stovícek P, Stojan M, Kasalický J, Vondrácek V, Vojácek J, Linhart A, Anger Z
Second Medical Department, First Faculty of Medicine, Charles University, Prague.
Physiol Res. 1993;42(2):109-17.
In this report, we dealt with ventricular activation abnormalities in 30 patients with previous non-Q myocardial infarction (MI) by means of the CARDIAG 128.1 device, which enables analysis of ECGs, VCGs and body surface potential maps. The diagnosis was verified by left ventriculography, echocardiography and perfusion scintigraphy. Twenty-nine healthy subjects served as the control group. Morphological findings confirmed the presence of a significant subgroup with serious left ventricular asynergy. Seven electrocardiological variables, which significantly differed from control values, disclosed that non-Q MI is responsible for localized activation time prolongation, and that inferoposterior scars tend to delay the entire activation of ventricles, and to cause disturbances of the terminal depolarization phase together with a decrease in voltage production during QRS. Lesions of the anterior wall and the apicomesial part of the inferoposterior wall affect the distribution of the Q wave more often than the posterior basal ones. The probability of such abnormalities increases with the degree of asynergy. Some VCG criteria increase the sensitivity of electrocardiological analysis. These parameters will be used for evaluating the diagnostic value of electrocardiological analysis in the chronic non-Q MI. Non-Q myocardial infarctions represent a heterogeneous group of infarctions from both electrophysiological and morphological aspects.
在本报告中，我们使用CARDIAG 128.1设备对30例既往有非Q波心肌梗死（MI）的患者的心室激活异常情况进行了研究，该设备能够分析心电图、心向量图和体表电位图。诊断通过左心室造影、超声心动图和灌注闪烁扫描进行验证。29名健康受试者作为对照组。形态学结果证实存在一个有严重左心室协同失调的显著亚组。七个与对照值有显著差异的心电图变量表明，非Q波心肌梗死导致局部激活时间延长，下后壁瘢痕往往会延迟心室的整体激活，并导致终末去极化期紊乱以及QRS期间电压产生降低。前壁和下后壁心尖内侧部分的病变比后基底部分更常影响Q波的分布。这种异常的可能性随着协同失调程度的增加而增加。一些心向量图标准提高了心电图分析的敏感性。这些参数将用于评估心电图分析在慢性非Q波心肌梗死中的诊断价值。非Q波心肌梗死从电生理和形态学方面来看都是一组异质性梗死。
