[A critical review of the stable changes in ventricular repolarization in ischemic cardiopathy. A correlation with the angiographic findings].
Unknown is the significance of the abnormalities of repolarization observed at rest in patients with coronary artery disease (CAD) demonstrated by coronary angiography, except for ischemic episodes, myocardial infarction, left ventricular hypertrophy, electrolyte changes or pharmacological interactions. The chronic T wave inversion and ST segment depression are usually considered as an alteration due to ischemia ("chronic myocardial ischemia"); this definition is, in our opinion, erroneous, because myocardial ischemia is an acute episode caused by a sudden lack of balance between demand and availability of myocardial oxygen, corresponding to transient electrocardiographic alterations. Thus, the definition of "chronic myocardial ischemia" referred to stable abnormalities of repolarization is incorrect, because a "chronic" lack of balance between MVO2 and O2 availability would produce necessarily irreversible myocardial damage (necrosis). To contribute to the comprehension of the stable ECG changes at rest, we have selected a group of patients with CAD demonstrated by coronary angiography, presenting stable T wave alterations and ST depression at rest. We have studied the main and regional left ventricular function through radionuclide angiocardiography (ACS). Comparing the abnormalities of repolarization (ECG) on the one hand with angio, EFR and VER on the other, we have obtained different positive correlations, according to the functional parameters considered (EFR and VER). In our study, the lowest positive correlation has been noticed comparing ECG versus angio, VER and EFR (37.5%), while the highest correlation was obtained when ECG was considered versus angio and VER (56.25%). Evaluating ECG versus angio and EFR we have obtained a positive correlation equal to 43.75%. So we have deduced that VER is the functional parameter that better relates to angio and ECG.(ABSTRACT TRUNCATED AT 250 WORDS)
Strozzi
C
C
Istituto di Medicina Interna, Università degli Studi di Ferrara.
Pratola
C
C
Spisani
P
P
Zanella
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology*; D011859:Radiography; D012146:Rest / Q000502:physiology; D013667:Technetium
D013667:Technetium
Revisione critica delle alterazioni stabili della ripolarizzazione ventricolare nella cardiopatia ischemica. Correlazione con i reperti angiografici.