Abstract

Clinical studies have demonstrated the predictive values of changes in electrocardiographic (ECG) parameters for the preexisting myocardial ischemic infarction. However, a simple and early predictor for the subsequent development of myocardial infarction during the ischemic phase is of significant value for the identification of ischemic patients at high risk. The present study was undertaken by using non-human primate model of myocardial ischemic infarction to fulfill this gap. Twenty male Rhesus monkeys at age of 2–3 years old were subjected to left anterior descending artery ligation. This ligation was performed at varying position along the artery so that it produced varying sizes of myocardial infarction at the late stage. The ECG recording was undertaken before the surgical procedure, at 2 h after the ligation, and 8 weeks after the surgery for each animal. The correlation of the changes in the ECG waves in the early or the late stage with the myocardial infarction size was analyzed. The R wave depression and the QT shortening in the early ischemic stage were found to have an inverse correlation with the myocardial infarction size. At the late stage, the R wave depression, the QT prolongation, the QRS score, and the ST segment elevation were all closely correlated with the developed infarction size. The poor R wave progression was identified at both the early ischemic and the late infarction stages. Therefore, the present study using non-human primate model of myocardial ischemic infarction identified the decreases in the R wave and the QT interval as early predictors of myocardial infarction. Validation of these parameters in clinical studies would greatly help identifying patients with myocardial ischemia at high risk for the subsequent development of myocardial infarction.

Highlights

  • The early diagnosis and identification of high-risk patients with myocardial infarction is a practical problem in clinical setting

  • The analyses of correlation between the ECG wave changes at 2 h or 8 wks and the size (%) of myocardial infarction were conducted for R wave amplitude, QRS score, QT interval, and ST segment elevation

  • At 2 h after the left anterior descending (LAD) ligation, the R wave amplitude decreased as a function of the increase in the infarction size observed at the end of 8 wks after the surgery

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Summary

Introduction

The early diagnosis and identification of high-risk patients with myocardial infarction is a practical problem in clinical setting. ST-segment elevation is a well recognized change in ECG recording in patients with myocardial infarction [5]. Not all patients with myocardial infarction are associated with ST-segment elevation and not all ST segments elevation is caused by myocardial infarction [6]. It was conventionally defined as ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). The percentage of MI cases with STsegment elevation varies in different registries/databases and depends heavily on the age of patients included and the type of surveillance used. About 29% of US inhospital patients with MI are STEMI [7], whereas 47% of European patients with MI are STEMI [8]

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