ST-segment mapping. Realistic and unrealistic expectations.

Braunwald, Eugene; Maroko, Peter R.

doi:10.1161/01.cir.54.4.529

Cited by 70 publications

(9 citation statements)

References 48 publications

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“…Histochemical (9), metabolic (10), electrocardiographic (11)(12)(13)(14), rheological (15,16), enzymatic (6), scintigraphic (17), and histologic (18) studies of jeopardized zones of myocardium have been carried out in experimental animals. However, the relationship between these parameters of ischemic injury and the segmental contractile properties of ventricular myocardium is unresolved.…”

mentioning

confidence: 99%

Functional characterization of left ventricular segmental responses during the initial 24 h and 1 wk after experimental canine myocardial infarction.

Roan¹,

Scales²,

Saffer³

et al. 1979

J. Clin. Invest.

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mentioning

confidence: 99%

Functional characterization of left ventricular segmental responses during the initial 24 h and 1 wk after experimental canine myocardial infarction.

Roan¹,

Scales²,

Saffer³

et al. 1979

J. Clin. Invest.

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“…In this model, LVEDP, heart rate, temperature, pH, Pot and Pco2 of perfused blood were also controlled. Those parameters may affect the ST segment deviation (Braunwald and Maroko 1976). In most previous experimental studies of coronary flow reduction, the authors did not control such parameters.…”

Section: Resultsmentioning

confidence: 99%

The effect of heart rate and left ventricular end-diastolic pressure on the direction of ST segment displacement in acute ischemia.

Ino-Oka

Kitaoka

Shimizu

et al. 1984

Tohoku J. Exp. Med.

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The correlation between the ST segment displacement and coronary blood flow in various hemodynamic conditions was studied. Five isolated, isovolumic contracting canine hearts were used. The left main and the right and left circumflex (LCx) coronary arteries were cannulated and perfused with support dog's arterial blood. Four pairs of Ag-AgCI ECG electrodes were attached to the epicardium and subendocardium in the LCx perfused area. Heart rate and left ventricular end-diastolic pressure (LVEDP) were controlled by means of right atrial electrical pacing and infusion or withdrawal of arterial blood into the left ventricle, respectively. LCx flow was reduced by 75, 50, 25% of the control level under the condition of 200 beats/min of heart rate and 20 mmHg or 5 mmHg of LVEDP, and ECGs were recorded. The ST segment elevation was observed in epi-and subendocardial lead ECGs when LCx flow was reduced from 110+27.5 ml/min/100 g to 72+3 ml/min/100 g under the condition of normal LVEDP (5 mmHg) and a high heart rate (200 beats/min), whereas the same degree of reduction in LCx flow under the condition of high LVEDP (20 mmHg) and high heart rate (200 beats/min) resulted in an epicardial ST segment depression associated with marked subendocardial ST segment elevation. The results suggest that the coronary flow reduction with a higher LVEDP will induce subendocardial ischemia, whereas the same degree flow reduction with a nomal LVEDP induce transmural ischemia.ST segment deviation ; heart rate ; LVEDP ; coronary blood flow ; angina pectoris

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“…'4 Clinical studies have proved the efficacy of 207T1 imaging in detecting myocardial ischemia or scar. Good qualitative relationships between location of 20ITI myocardial perfusion defects and electrocardiography, 7 ventriculography,'8 cardiac enzymes,'0 coronary angiography, 17. 18 or postmortem studies9 have been reported; but several clinical studies9' 19,20 have suggested that the accuracy of planar imaging for sizing myocardial infarction is only fair.…”

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confidence: 99%

Estimation of infarct size by myocardial emission computed tomography with thallium-201 and its relation to creatine kinase-MB release after myocardial infarction in man.

Tamaki¹,

Nakajima²,

Murakami³

et al. 1982

Circulation

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SUMMARY We evaluated emission computed tomography (ECT) for thallium-201 (201TI) myocardial imaging in estimating infarct size (IS). In 18 patients in whom IS was estimated enzymatically at the time of the acute episode, planar 2"1T1 perfusion scintigraphy and ECT with a rotating gamma camera were performed 4 weeks after the first myocardial infarction. From the size of 201T1 perfusion defects, the infarct area in planar images and the infarct volume in reconstructed ECT images, were measured by computerized planimetry. When scintigraphic IS was compared with the accumulated creatine kinase-MB isoenzyme release (CK-MBr), infarct volume determined from ECT correlated closely with CK-MBr -(r 0.89), whereas infarct area measured from planar images correlated less satisfactorily with the enzymatic IS (for an average infarct area from three views, r = 0.69; for the largest infarct area, r = 0.73). Although conventional scintigraphic evaluation is useful for detecting and localizing infarction, quantification of ischemic injury with this two-dimensional technique has a significant inherent limitation. The ECT approach can provide a more accurate three-dimensional quantitative estimate of infarction, and can corroborate the enzymatic estimate of IS.

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ST-segment mapping. Realistic and unrealistic expectations.

Cited by 70 publications

References 48 publications

Functional characterization of left ventricular segmental responses during the initial 24 h and 1 wk after experimental canine myocardial infarction.

Functional characterization of left ventricular segmental responses during the initial 24 h and 1 wk after experimental canine myocardial infarction.

The effect of heart rate and left ventricular end-diastolic pressure on the direction of ST segment displacement in acute ischemia.

Estimation of infarct size by myocardial emission computed tomography with thallium-201 and its relation to creatine kinase-MB release after myocardial infarction in man.

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