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Observation of Sequence and Dispersion of Epicardium Repolarization before and after Acute Myocardial Infarction in Swine

Author: ZhangDaPeng
Tutor: WangZuLu
School: Dalian Medical University
Course: Internal Medicine
Keywords: Acute myocardial infarction Ventricular fibrillation Monophasic action potential Repolarization end time The ventricular repolarization discrete degrees
CLC: R542.22
Type: Master's thesis
Year: 2008
Downloads: 20
Quote: 0
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Abstract


Background and Purpose: With the extension of human life and the aging of the population, coronary atherosclerotic heart disease has become one of the major diseases of harm to human health and life, acute myocardial infarction (Acute myocardial infarction, AMI) is the leading cause of death major diseases, the high incidence of AMI patients with early ventricular arrhythmias (Ventricular arrhythmia, VA), ventricular fibrillation (Ventricular fibrillation, VF) is the leading cause of death in AMI patients before admission. VF appears in the first 4h of AMI symptoms after accounting for all VF 60% within 12h VF accounted for 80%. The GISSI trial results VF episodes in patients with significantly increased mortality during hospitalization. Clinical AMI occurred in the left ventricle, the vicious VA mostly originated in the left ventricle. The left anterior descending artery (Left anterior descending, LAD) is the major blood vessels that supply of the left ventricle, so choose the ligation of LAD to study after AMI and infarct-related myocardial repolarization process, help to understand the VA matrix. The increase in ventricular repolarization dispersion (Dispersion of ventricular repolarization, DVR) is an important mechanism for tachyarrhythmias occurred. Monophasic action potential (Monophasic action potential, MAP) to study myocardial repolarization addition to the pole and useful tool. Electro-anatomical mapping system (CARTO system) can be accurate anatomical localization of each point and the corresponding point of the MAP information recorded. The experiment that the CARTO system and MAP mapping technology to combine the left ventricular epicardial mapping ligation of LAD before and after MAP repolarization overall analysis of left ventricular repolarization sequence and the DVR to explore the VF after AMI pathogenesis. Methods: 5 healthy pigs anesthetic after thoracotomy, the heart was exposed after LAD ligation of the left ventricular epicardial MAP mapping, ligation of LAD in sinus rhythm after ligation of 10min and 2h time scale measured epicardial MAP. Immediately, the occurrence of the VF line epicardial defibrillation, defibrillator, heart rate, rhythm stability continue mapping. Mapping indicators include: local activation time (Local activation time, LAT) refers to the local excitement began from the earliest recorded ventricular excitement; repolarization end time (End of repolarization time, EORT) refers to the earliest recorded ventricular excited to local repolarization time of the end; monophasic action potential (MAP duration, MAPD) ??refers to the local excitement beginning to the local repolarization the end of time, equal EORT minus the LAT; dispersion of repolarization (DVR) refers EORT maximum minus EORT minimum (EORTmax-EORTmin). Results: The 5 pigs, were conducted before the ligation of LAD left ventricular epicardial MAP mapping, mapping records in the left ventricular epicardial per 2cm2 area at least one of the MAP, an average of 43 ± 8 in each pig left ventricular The loci record MAP. A total of 5 sets of left ventricular three-dimensional anatomical mapping. Ligation of LAD former pig left ventricular epicardial complex pole order is basically the same with the exception of a very sequence. Linear correlation analysis showed that: the MAPD with AT into a negative linear correlation (p lt; 0.01),, while EORT with AT into a positive linear correlation (p lt; 0.01). Ligation of LAD after mapping process, one cases occurred in the ligation of LAD to ventricular fibrillation deaths; infarct zone epicardial mapping, mapping covers four cases, the non-infarcted area, border zone. Mapping process, the experimental animals heart rate and heart rate were greater change only after ligation of LAD mapping each point in time heart rate and rhythm is more constant. MAP mapping records point significantly reduced compared with before ligation failed MAPD and AT linear correlation and regression analysis, not after LAD ligation of depolarization and repolarization sequence analysis. 4 pigs before ligation DVR to 41.3 ± 7.9ms; the ligation after 10minDVR 95.5 ± 7.7 ms; 2h DVR after ligation of 81.3 ± 4.0ms. Ligation after 10min (p = 0.0035) and ligation after 2h (p = 0.0072) DVR than ligation significantly increased. Conclusion: ligation of LAD former pig left ventricular epicardial complex pole order basic depolarization sequence of the same immediate early depolarization partial early repolarization. Before ligation of LAD epicardial mapping MAPD AT into negative linear,, while EORT with AT a positive linear correlation. Than before ligation of the the pigs left ventricular epicardial DVR significantly increased after ligation of LAD.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Myocardial diseases > Myocardial infarction
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