Ischemia-induced repolarization response in relation to the size and location of the ischemic myocardium during short-lasting coronary occlusion in humans.
BACKGROUND
The ventricular repolarization (VR) response to short-lasting coronary occlusion has been characterized by 3-dimensional vectorcardiography (VCG) in humans; the T vector loop becomes distorted and more circular. The purpose of this study was to relate these changes to the size of the myocardium at risk (MAR) and its location.


METHODS
Continuous VCG was applied during transient coronary occlusion in 35 elective angioplasty patients, and the size of the MAR was estimated by single-photon emission computed tomography. Three VR aspects were assessed at baseline vs maximum ischemia: the ST segment, the T vector angles, and the T vector loop morphology.


RESULTS
The T loop morphology changes were significantly associated with MAR size, but also dependent of its location. In contrast, the early phase of VR reflected by the ST segment responded to acute ischemia in relation to the MAR size independent of location.


CONCLUSIONS
The VR changes were related both to the size and the location of the MAR and most pronounced during occlusion of the left anterior descending artery.
Rubulis
Aigars
A
Department of Cardiology, Karolinska University Hospital Solna, Karolinska Institutet, Sweden.
Jensen
Steen M
SM
Näslund
Ulf
U
Lundahl
Gunilla
G
Jensen
Jens
J
Bergfeldt
Lennart
L
D023921:Coronary Stenosis / Q000150:complications* / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis*; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*