Ionic mechanisms of ST segment elevation in electrocardiogram during acute myocardial infarction View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-07-13

AUTHORS

Jun-ichi Okada, Katsuhiko Fujiu, Kazunori Yoneda, Takashi Iwamura, Takumi Washio, Issei Komuro, Toshiaki Hisada, Seiryo Sugiura

ABSTRACT

ST elevation on an electrocardiogram is a hallmark of acute transmural ischemia. However, the underlying mechanism remains unclear. We hypothesized that high ischemic sensitivities of epicardial adenosine triphosphate-sensitive potassium (IKATP) and sodium (INa) currents play key roles in the genesis of ST elevation. Using a multi-scale heart simulation under moderately ischemic conditions, transmural heterogeneities of IKATP and INa created a transmural gradient, opposite to that observed in subendocardial injury, leading to ST elevation. These heterogeneities also contributed to the genesis of hyper-acute T waves under mildly ischemic conditions. By contrast, under severely ischemic conditions, although action potentials were suppressed transmurally, the potential gradient at the boundary between the ischemic and normal regions caused ST elevation without a contribution from transmural heterogeneity. Thus, transmural heterogeneities of ion channel properties may contribute to the genesis of ST–T changes during mild or moderate transmural ischemia, while ST elevation may be induced without the contribution of heterogeneity under severe ischemic conditions. More... »

PAGES

36

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12576-020-00760-3

DOI

http://dx.doi.org/10.1186/s12576-020-00760-3

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https://app.dimensions.ai/details/publication/pub.1129324109

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32660418


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