Relation Between the Initial Portion of the Signal-Averaged QRS Complex and Cardiac Function and Infarct Size in Patients With Myocardial Infarction

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We analyzed signal-averaged electrocardiograms (ECG) obtained in 50 patients with recent myocardial infarction (RMI:25 anterior and 25 inferior) and 20 normal subjects to determine the relationship between the initial portion of the signal-averaged QRS complex and cardiac function and infarct size. We examined (1) the root mean square voltage (RMS_<10-40>, μV), (2) the integration (A_<10-40>, μV・msec) at 10-msee intervals over the first 40 msec of the signal-averaged QRS complex, and (3) the intervals (T) of the magnitude of the signal-averaged ECG achieved at 10-μV intervals over the first 40μV (T_<10-40>, msec). The mean RMS_<10-40> (p<0.01) and A ^<10-40> (A_<10>, p<0.05; A_<20-40>, p<0.01) were significantly lower and the T_<10-40> (p<0.01) was significantly longer in RMI patients than in normal subjects. The RMS_<10-40> (p<0.01) and A_<10-40> (p<0.05) were significantly lower and the T_<10-40> (T_<10, 20>, p<0.01; T_<30, 40>, p<0.05) was significantly longer in patients with anterior RMI patients than in patients with inferior RMI. The A_<30> was correlated with the ejection fraction and total creatine kinase (CK) release in all patients (r=0.73, and -0.78, respectively, p<0.001). These results suggest that the A_<30> may be an important predictor of ventricular dysfunction and infarct size in patients with RMI.
社団法人日本循環器学会の論文
1997-03-20