在缺血期间成像心电学分散脱极化和再极化:同时测绘身体表面和心脏表皮图
Martyn P Nash1, Chris P Bradley, David J Paterson
1University Laboratory of Physiology, University of Oxford, Oxford, UK. martyn.nash@auckland.ac.nz
Circulation
|April 23, 2003
概括
高分辨率的干心电图绘制有效地识别了心肌缺血期间心室再极化分散的变化,与标准的12导心电图不同. 这为患有心脏病的患者的风险分层提供了一个有前途的工具.
科学领域:
- 电子生理学 电子生理学
- 心血管研究研究心血管研究
- 医疗成像医学成像
背景情况:
- 心肌缺血可以通过改变心脏的电特性,导致危险的心室节律失常.
- 目前使用身体表面电力测量识别风险患者的方法仍在争论中.
- 这项研究探讨了干电力测量在检测缺血期间变化的实用性.
研究的目的:
- 评估干心电图测量的灵敏度,以检测局部心室缺血期间的电变化.
- 为了将高分辨率的干心电图映射与标准的12导心电图进行比较,以识别复极化异常.
- 在诱导性缺血期间调查心上电图和干心电图信号之间的关系.
主要方法:
- 在麻醉猪中同时记录心表电图和高密度的干心电图.
- 使用冠状动脉绑定模型诱导局部心肌缺血.
- 从心表和干数据计算激活-恢复间隔 (ARI) 和分散量 (QTu,RTu).
- 使用解剖学定制的计算模型进行分析.
主要成果:
- 左前下垂动脉 (LAD) 阻塞显著增加了心上脏ARI的分散,转移了最短的ARI的位置.
- 干RTu分散也增加了,最短的RTu间隔在干中迁移.
- 标准的12导电心电图测量QTu和RTu分散不一致地反映了观察到的心肌变化.
结论:
- 高分辨率的干心电图绘制可以在局部缺血期间可靠地检测心肌复极化分散变化.
- 标准的12导心电图指数不足以准确反映这些缺血引起的再极化异常.
- 干心电图绘制显示,在易患心室失常症的患者中,有可能改善风险分层.
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