Evaluation of depolarization changes during acute myocardial ischemia by analysis of QRS slopes.

Authors :: Ringborn M
Romero D
Pueyo E
Pahlm O
Wagner GS
Laguna P
Platonov PG
Source :: Journal of electrocardiology [J Electrocardiol] 2011 Jul-Aug; Vol. 44 (4), pp. 416-24. Date of Electronic Publication: 2011 Apr 27.
Publication Year :: 2011
Abstract: Objective: This study evaluates depolarization changes in acute myocardial ischemia by analysis of QRS slopes.<br />Methods: In 38 patients undergoing elective percutaneous coronary intervention, changes in upward slope between Q and R waves and downward slope between R and S waves (DS) were analyzed. In leads V1 to V3, upward slope of the S wave was additionally analyzed. Ischemia was quantified by myocardial scintigraphy. Also, conventional QRS and ST measures were determined.<br />Results: QRS slope changes correlated significantly with ischemia (for DS: r = 0.71, P < .0001 for extent, and r = 0.73, P < .0001 for severity). Best corresponding correlation for conventional electrocardiogram parameters was the sum of R-wave amplitude change (r = 0.63, P < .0001; r = 0.60, P < .0001) and the sum of ST-segment elevation (r = 0.67, P < .0001; r = 0.73, P < .0001). Prediction of extent and severity of ischemia increased by 12.2% and 7.1% by adding DS to ST.<br />Conclusions: The downward slope between R and S waves correlates with ischemia and could have potential value in risk stratification in acute ischemia in addition to ST-T analysis.<br /> (Copyright © 2011 Elsevier Inc. All rights reserved.)

Subjects :: Adult
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Female
Humans
Linear Models
Male
Middle Aged
Myocardial Ischemia diagnostic imaging
Myocardial Ischemia therapy
Radionuclide Imaging
Radiopharmaceuticals administration & dosage
Risk Assessment
Statistics, Nonparametric
Technetium Tc 99m Sestamibi administration & dosage
Electrocardiography methods
Heart Conduction System physiopathology
Myocardial Ischemia physiopathology

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