Ischemic QRS prolongation as a biomarker of severe myocardial ischemia
Jakob Almer1, Robert B Jennings2, Arie C Maan3
1Department of Clinical physiology and Nuclear medicine, Skåne University Hospital and Lund University, Lund, Sweden.
Insights
Ischemic QRS prolongation, a sign of reduced blood flow during heart attacks, correlates with collateral flow in dogs. This pattern of QRS prolongation during ischemia is similar in dogs and humans, suggesting its potential as a biomarker.
Area of Science:
- Cardiology
- Biomarkers
- Myocardial Ischemia
Background:
- QRS prolongation indicates reduced collateral flow and increased myocardial cell death during coronary occlusion.
- Previous research suggests QRS changes as indicators of cardiac events.
Purpose of the Study:
- To evaluate ischemic QRS prolongation as a biomarker for severe myocardial ischemia.
- To establish the relationship between QRS prolongation and collateral flow in a canine model.
- To determine if ischemic QRS prolongation patterns are consistent between dogs and humans.
Main Methods:
- A novel method was used to measure ischemic QRS prolongation in dogs (n=23) and patients (n=52).
- Coronary occlusion was induced for 5 minutes in both groups.
- Collateral arterial flow was assessed in the canine subjects.
Main Results:
- A significant correlation was found between QRS prolongation and collateral flow in dogs (r=0.61, p=0.008).
- The magnitude and temporal progression of QRS prolongation during ischemia were comparable between dogs and humans (p=0.202 and p=0.911, respectively).
Conclusions:
- Quantification of ischemic QRS prolongation shows potential as a reliable biomarker for severe myocardial ischemia.
- The findings support the translational relevance of using QRS prolongation as an indicator of ischemic severity across species.
Background:
Previous studies have shown that QRS prolongation is a sign of depressed collateral flow and increased rate of myocardial cell death during coronary occlusion. The aims of this study were to evaluate ischemic QRS prolongation as a biomarker of severe ischemia by establishing the relationship between prolongation and collateral flow experimentally in a dog model, and test if the same pattern of ischemic QRS prolongation occurs in man.
Methods:
Degree of ischemic QRS prolongation was measured using a novel method in dogs (n=23) and patients (n=52) during coronary occlusion for 5min. Collateral arterial flow was assessed in the dogs.
Results:
There was a significant correlation between QRS prolongation and collateral flow in dogs (r=0.61, p=0.008). Magnitude and temporal evolution of prolongation during ischemia were similar for dogs and humans (p=0.202 and p=0.911).
Conclusion:
Quantification of ischemic QRS prolongation could potentially be used as a biomarker for severe myocardial ischemia.
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