Document Detail


ST-Segment Deviation Behavior During Acute Myocardial Ischemia in Opposite Ventricular Regions. Observations in the Intact and Perfused Heart.
MedLine Citation:
PMID:  25041965     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Acute myocardial ischemia in opposite regions may attenuate the ST-segment changes but whether this effect is expressed differently in extracardiac compared to direct intramyocardial recordings, is not well known.
OBJECTIVE: To characterize ST-segment changes induced by opposite ischemic regions in intact and isolated perfused pig hearts.
METHODS: Left anterior descending (LAD) and right coronary arteries (RCA) were occluded in 7 closed chest pigs and in 5 isolated pig hearts. ST-segment changes were analyzed in 12-lead ECG and in local extracellular electrograms.
RESULTS: Isolated LAD or RCA occlusion induced maximal ST-segment elevation in leads V4 (0.84 ± 0.30 mV, p=0.003) and III (0.16 ± 0.11 mV, p=0.04), respectively. RCA occlusion also induced reciprocal ST-segment depression maximal in lead V4 (-0.40 ± 0.16 mV, p=0.005). Simultaneous LAD and RCA occlusion reduced ST-segment elevation by about 60% and blunted the reciprocal ST-segment changes. Reperfusion of one of the two occluded arteries induced immediate regional reversion of ST-segment elevation with concurrent beat-to-beat reelevation in the opposite ischemic region and reappearance of reciprocal ST-segment changes. In the isolated heart, single LAD or RCA ligature induced regional transmural ST-segment elevation maximal in endocardial electrograms with no appreciable reciprocal ST-segment depression. Simultaneous LAD and RCA ligature reduced the ST segment elevation by about 30% with no appreciable reelevation after one vessel selective reperfusion.
CONCLUSION: Acute myocardial ischemia in opposite ventricular regions attenuated the ST-segment elevation and blunted the reciprocal depression in the conventional ECG leads but not in direct local myocardial electrograms.
Authors:
Juan Cinca; Francisco Javier Noriega; Esther Jorge; Jesús Alvarez-Garcia; Gerard Amoros; Dabit Arzamendi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-17
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
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