Jung J, Heisel A, Bay W, Fries R, Schieffer H, Ozbek C
Medizinische Universitätsklinik, Universitätskliniken des Saarlandes, Homburg/Saar, Germany.
Pacing Clin Electrophysiol. 1996 Nov;19(11 Pt 2):1909-13. doi: 10.1111/j.1540-8159.1996.tb03251.x.
The intraindividual changes of ventricular late potentials and their possible determinants were examined prospectively in 88 consecutive patients (male: 75; mean age: 58 +/- 9 years) after thrombolytic therapy for acute myocardial infarction. Late potential analysis was performed 4 weeks and 12 months after acute myocardial infarction. At the same time, a left heart catheterization was performed to assess the extent of coronary heart disease and left ventricular ejection fraction. The incidence of late potential 4 weeks after acute myocardial infarction was 15% (13/88 patients). Eighteen percent (16/88) of the patients revealed changing results of late potential analysis: 9 patients lost late potential (late potential pos./neg.) 1 year after acute myocardial infarction and 7 patients presented new formation of late potential (late potential neg./pos.). Preserved late potentials were found in four patients (late potential pos./pos.). Late potential analysis remained negative in 68 patients (late potential neg./neg.). There was no influence of age, gender, site of infarction, clinical course, and medical treatment on the natural course of late potential. Changing results of late potential analysis seemed to be correlated with the evolution of left ventricular ejection fraction and the dynamics of coronary heart disease. In the group late potential pos./pos., comparable values for left ventricular ejection fraction were measured at both examinations, whereas late potential neg./neg. had a significant increase in ejection fraction. In the group late potential pos./neg., a significant improvement in left ventricular function was also measured. In contrast, the late potential neg./pos. group tended to have lower left ventricular ejection fractions 1 year after infarction. In the late potential neg./pos. and late potential pos./pos. groups, the extent of coronary artery disease returned to conditions comparable to baseline despite an initial reduction after coronary revascularization performed 4 weeks after infarction. Late potential neg./neg. and late potential pos./neg. revealed a stable benefit gained from coronary revascularization with a persistent reduction in the number of diseased vessels. Dynamic changes in the results of the signal-averaged ECG 1 year after thrombolytic therapy for acute myocardial infarction were observed in 18% of the patients. These changes seem to be correlated with the evolution of left ventricular function and the dynamics of coronary artery disease.
对88例急性心肌梗死溶栓治疗后的连续患者（男性75例，平均年龄58±9岁）进行前瞻性研究，观察心室晚电位的个体内变化及其可能的决定因素。在急性心肌梗死后4周和12个月进行晚电位分析。同时，进行左心导管检查以评估冠心病的程度和左心室射血分数。急性心肌梗死后4周晚电位的发生率为15%（13/88例患者）。18%（16/88）的患者晚电位分析结果发生变化：9例患者急性心肌梗死后1年晚电位消失（晚电位阳性/阴性），7例患者出现新的晚电位形成（晚电位阴性/阳性）。4例患者晚电位持续存在（晚电位阳性/阳性）。68例患者晚电位分析仍为阴性（晚电位阴性/阴性）。年龄、性别、梗死部位、临床病程和治疗对晚电位的自然病程无影响。晚电位分析结果的变化似乎与左心室射血分数的演变和冠心病的动态变化相关。在晚电位阳性/阳性组中，两次检查时左心室射血分数的测量值相当，而晚电位阴性/阴性组射血分数有显著增加。在晚电位阳性/阴性组中，左心室功能也有显著改善。相比之下，晚电位阴性/阳性组在梗死后1年左心室射血分数往往较低。在晚电位阴性/阳性组和晚电位阳性/阳性组中，尽管梗死4周后进行冠状动脉血运重建后冠状动脉疾病程度最初有所降低，但1年后冠状动脉疾病程度恢复到与基线相当的水平。晚电位阴性/阴性组和晚电位阳性/阴性组显示冠状动脉血运重建带来了稳定的益处，病变血管数量持续减少。急性心肌梗死溶栓治疗1年后，18%的患者观察到信号平均心电图结果的动态变化。这些变化似乎与左心室功能的演变和冠状动脉疾病的动态变化相关。
