title: Transient repolarization alterations dominate the initial phase of an acute anterior infarction--a vectorcardiography study.
abstract: OBJECTIVE
  To study effects of ischemia-reperfusion on ventricular electrophysiology in humans by three-dimensional electrocardiography.
  
  
  METHODS
  Fifty-seven patients with first-time acute anterior ST elevation myocardial infarction were monitored from admission and >24h after symptom onset with continuous vectorcardiography (VCG; modified Frank orthogonal leads). Global ventricular depolarization and repolarization (VR) measures were compared at maximum vs. minimum ST vector magnitude (STVM) (median 208; 111-303 vs. 362; 165-1359min after symptom onset).
  
  
  RESULTS
  At maximum vs. minimum STVM the Tarea (overall VR dispersion) almost tripled (118 vs. 41μVs; p<0.0001), the T-loop bulginess was 90% greater (Tavplan 0.91 vs 0.48μV; p<0.0001), and Tpeak-end/QT was 39% larger (0.32 vs 0.23; p<0.0001). QRSarea (overall dispersion of depolarization) was 12% larger at maximum STVM, while QRS duration was 10% longer at minimum STVM.
  
  
  CONCLUSIONS
  Ischemia-reperfusion was accompanied by profound and transient alterations of VR dispersion, while changes in depolarization were modest and delayed.
authors.affiliation: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, Halland Hospital, Varberg, Sweden. Electronic address: markus.lingman@regionhalland.se.
authors.forename: Markus
authors.initials: M
authors.lastname: Lingman
authors.affiliation: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Marianne
authors.initials: M
authors.lastname: Hartford
authors.affiliation: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.affiliation: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Center of Prehospital Research in Western Sweden, University of Borås, Borås, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
authors.affiliation: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Aigars
authors.initials: A
authors.lastname: Rubulis
authors.affiliation: Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Caidahl
authors.affiliation: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Lennart
authors.initials: L
authors.lastname: Bergfeldt
mesh_terms: D000208:Acute Disease; D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014672:Vectorcardiography / Q000379:methods*; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000209:etiology
keywords: Acute coronary syndromes; Coronary artery disease; Electrocardiography; Myocardial ischemia; Vectorcardiography