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Related Experiment Videos

Nonischemic ST-segment elevation induced by negative inotropic agents.

M Shimada1, Y Nakamura, S Iwanaga

  • 1Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan. shimada-m@kitasato.or.jp

Japanese Circulation Journal
|September 9, 1999
PubMed
Summary

Regional ventricular dyskinesia, or systolic bulging, can directly cause ST-segment elevation in canine hearts. This occurs even without myocardial ischemia, suggesting a new understanding of cardiac electrical abnormalities.

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Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Myocardial Mechanics

Background:

  • ST-segment elevation typically indicates myocardial ischemia.
  • The precise mechanisms causing ST-segment elevation in the absence of ischemia are not fully understood.
  • Regional ventricular dyskinesia is characterized by abnormal systolic outward movement.

Purpose of the Study:

  • To investigate if regional ventricular dyskinesia directly causes ST-segment elevation in canine hearts.
  • To differentiate the effects of dyskinesia from myocardial ischemia on ST-segment changes.
  • To explore the role of various pharmacological agents in inducing dyskinesia and ST elevation.

Main Methods:

  • Induction of regional ventricular dyskinesia using negative inotropic agents in anesthetized dogs.

Related Experiment Videos

  • Measurement of percent systolic shortening (%SS) and percent systolic bulging (%bulging) via ultrasonic crystals.
  • Recording of ST-segment elevation using unipolar electrodes in the left anterior descending artery (LAD) perfused area.
  • Administration of lidocaine, nicorandil, propranolol, or verapamil to assess their effects on dyskinesia and ST segments.
  • Confirmation of the absence of myocardial ischemia using NADH fluorescence.

    • Main Results:

    • Pharmacological induction of regional ventricular dyskinesia led to dose-dependent ST-segment elevation.
    • A parallel reduction in %SS and increase in %bulging correlated with ST-segment elevation.
    • ST-segment elevation occurred without evidence of myocardial ischemia (NADH fluorescence negative).
    • All tested drugs (lidocaine, nicorandil, propranolol, verapamil) induced these effects.

    Conclusions:

    • Regional ventricular dyskinesia plays a significant role in causing ST-segment elevation.
    • ST-segment elevation can occur independently of myocardial ischemia.
    • These findings challenge the traditional view linking ST-segment elevation solely to ischemic events.