Open AccessHigh-definition electrocardiography potential in identifying the reasons for unstable clinical course of coronary heart disease
Author(s) -
И. А. Латфуллин,
З. Ф. Ким,
Г. М. Тептин,
Л. Э. Мамедова,
Angelina Khromova
Publication year - 2011
Publication title -
kardiovaskulârnaâ terapiâ i profilaktika
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.158
H-Index - 16
eISSN - 2619-0125
pISSN - 1728-8800
DOI - 10.15829/1728-8800-2011-3-51-57
Subject(s) - medicine , cardiology , electrocardiography , myocardial infarction , unstable angina , angina , heart failure , acute coronary syndrome , st segment
Aim. To investigate the correlation between clinical and morphological characteristics of coronary heart disease (CHD) and high-definition electrocardiography (HD-ECG) parameters. Material and methods. In total, 85 patients with unstable angina and ST segment depression (ST-UA) underwent HD-ECG during the angina attack, with late ventricular potential (LVP) analysis. One-year survival data were also analysed. Post-mortem histological examination of cardiac tissue was performed in 6 patients with ST-UA. Results. The important morphologic features of ST-UA included cardiomyocyte (CMC) dystrophy, due to acute and chronic myocardial ischemia, and acute injury in the cardiac conduction areas. LVPs were registered in 27 % of the ST-UA patients, mostly among people with transient myocardial ischemia (69,57 %). In patients who previ-ously underwent myocardial infarction, LVP prevalence was lower (28,57 %). At the early stages of hospitalization, LVP were registered in 14 patients (60,87 %), while pharmacotherapy and clinical course stabilization were associated with decreased LVP prevalence (21,74 %). The study results suggest that in patients with acute coronary syndrome, LVP registration predicts not an adverse outcome, but a better prognosis. Conclusion. ST-UA is characterised by typical changes of CMC and myocardial stroma in posterior septal area, which result in metabolic, energetic, and electrical myocardial instability. LVPs could be used as a marker of functional (ischemic) myocardial heterogeneity in patients with ST-UA. LVP registration could be associated with a better prognosis in this clinical group.