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Titolo:
Detailed endocardial mapping accurately predicts the transmural extent of myocardial infarction
Autore:
Wolf, T; Gepstein, L; Dror, U; Hayam, G; Shofti, R; Zaretzky, A; Uretzky, G; Oron, U; Ben-Haim, SA;
Indirizzi:
Technion Israel Inst Technol, Bruce Rappaport Fac Med, Cardiovasc Syst Lab, IL-31096 Haifa, Israel Technion Israel Inst Technol Haifa Israel IL-31096 L-31096 Haifa, Israel Technion Israel Inst Technol, Carmel Med Ctr, Dept Cardiothorac Surg, Haifa, Israel Technion Israel Inst Technol Haifa Israel diothorac Surg, Haifa, Israel Tel Aviv Univ, Dept Zool, IL-69978 Tel Aviv, Israel Tel Aviv Univ Tel Aviv Israel IL-69978 t Zool, IL-69978 Tel Aviv, Israel
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 6, volume: 37, anno: 2001,
pagine: 1590 - 1597
SICI:
0735-1097(200105)37:6<1590:DEMAPT>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
TWO-DIMENSIONAL ECHOCARDIOGRAPHY; CORONARY-OCCLUSION; CARDIOGENIC-SHOCK; RISK-FACTORS; Q-WAVE; SIZE; VIABILITY; QUANTIFICATION; PROGNOSIS; MODEL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Wolf, T Technion Israel Inst Technol, Bruce Rappaport Fac Med, Cardiovasc Syst Lab, Efron St,POB 9649, IL-31096 Haifa, Israel Technion Israel Inst Technol Efron St,POB 9649 Haifa Israel IL-31096
Citazione:
T. Wolf et al., "Detailed endocardial mapping accurately predicts the transmural extent of myocardial infarction", J AM COL C, 37(6), 2001, pp. 1590-1597

Abstract

OBJECTIVES This study delineates between infarcts varying in transmuralityby using endocardial electrophysiologic information obtained during catheter-based mapping. BACKGROUND The degree of infarct transmurality extent has previously been linked to patient prognosis and may have significant impact on therapeutic strategies. Catheter-based endocardial mapping may accurately delineate between infarcts differing in the transmural extent of necrotic tissue. METHODS Electromechanical mapping was performed in 13 dogs four weeks after left anterior descending coronary artery ligation, enabling three-dimensional reconstruction of the left ventricular chamber. A concomitant reduction in bipolar electrogram amplitude (BEA) and local shortening indicated theinfarcted region. In addition, impedance, unipolar electrogram amplitude (UEA) and slew rate (SR) were quantified. Subsequently, the hearts were excised, stained with 2,3,5-triphenyltetrazolium chloride and sliced transversely. The mean transmurality of the necrotic tissue in each slice was determined, and infarcts were divided into <30%, 31% to 60% and 61% to 100% transmurality subtypes to be correlated with the corresponding electrical data. RESULTS From the three-dimensional reconstructions, a total of 263 endocardial points were entered for correlation with the degree of transmurality (4.6 +/- 2.4 points from each section). All four indices delineated infarcted tissue. However, BEA (1.9 +/- 0.7 mV, 1.4 +/- 0.7 mV, 0.8 +/- 0.4 mV in the three groups respectively, p < 0.05 between each group proved superior to SR, which could not differentiate between the second (31% to 60%) and third (61% to 100%) transmurality subgroups, and to UEA and impedance, which could not differentiate between the first (<30%) and second transmurality subgroups. CONCLUSIONS The degree of infarct transmurality extent can be derived fromthe electrical properties of the endocardium obtained via detailed catheter-based mapping in this animal model. (J Am Coll Cardiol 2001;37:1590-7) (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 09:44:34