Med Biol Eng Comput - Evaluation of ventricular repolarization dispersion during acute myocardial ischemia: spatial and temporal ECG indices.


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In this work, we studied the evolution of different electrocardiogram (ECG) indices of ventricular repolarization dispersion (VRD) during acute transmural myocardial ischemia in 95 patients undergoing percutaneous coronary intervention (PCI). We studied both temporal indices of VRD (T-VRD), based on the time intervals of the ECG wave, and spatial indices of VRD (S-VRD), based on the eigenvalues of the spatial correlation matrix of the ECG. The T-wave peak-to-end interval I(TPE) index showed statistically significant differences during left anterior descending artery and right coronary artery (RCA) occlusion for almost the complete time course of the PCI procedure with respect to the control recording. Regarding S-VRD indices, we observed statistically significant increases in the ratio of second to the first eigenvalue I(T21), the ratio of the third to the first eigenvalue I(T31) and the T-wave residuum I(TWR) during RCA occlusions. We also found a statistically significant increase in the I(T31) during left circumflex artery occlusions. To evaluate the evolution of VRD indices during acute ischemia, we calculated the relative change parameter R(I) for each index I. Maximal relative changes (R(I)) during acute ischemia were found for the S-VRD indices I(T21), the first eigenvalue I(1) and the second eigenvalue I(2), with changes 64, 57 and 52 times their baseline range of variation during the control recording, respectively. Also, we found that relative changes with respect to the baseline were higher in patients with T-wave alternans (TWA) than in those without TWA. In conclusion, results suggest that I(TPE) as well as I(T21), I(T31) and I(TWR) are very responsive to dispersion changes induced by ischemia, but with a behavior which very much depends on the occluded artery.

Resumo Limpo

work studi evolut differ electrocardiogram ecg indic ventricular repolar dispers vrd acut transmur myocardi ischemia patient undergo percutan coronari intervent pci studi tempor indic vrd tvrd base time interv ecg wave spatial indic vrd svrd base eigenvalu spatial correl matrix ecg twave peaktoend interv itp index show statist signific differ left anterior descend arteri right coronari arteri rca occlus almost complet time cours pci procedur respect control record regard svrd indic observ statist signific increas ratio second first eigenvalu ratio third first eigenvalu twave residuum itwr rca occlus also found statist signific increas left circumflex arteri occlus evalu evolut vrd indic acut ischemia calcul relat chang paramet ri index maxim relat chang ri acut ischemia found svrd indic first eigenvalu second eigenvalu chang time baselin rang variat control record respect also found relat chang respect baselin higher patient twave alternan twa without twa conclus result suggest itp well itwr respons dispers chang induc ischemia behavior much depend occlud arteri

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