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January 1, 1999Japanese Circulation Journal-english EditionOpen Access

Nonischemic ST-Segment Elevation Induced by Negative Inotropic Agents

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Key result

Intracoronary injection of negative inotropic agents induced dose-dependent ST-segment elevation associated with a parallel reduction in systolic shortening and increase in systolic bulging.

Why the study?

Does regional ventricular dyskinesia induced by negative inotropic agents cause ST-segment elevation in the absence of myocardial ischemia in canine hearts?

Population

33 anesthetized open-chest mongrel dogs of either sex weighing 15-25 kg

Comparison

Intracoronary injection of negative inotropic… vs Intracoronary injection of nitroglycerin or…

Design

Preclinical

Follow-up

Acute

Authors

MSMegumi ShimadaTokyo Metropolitan UniversityYNYoshiro NakamuraKumoh National Institute of TechnologyKAKeiko AsakuraKeio University

Discussion

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Implication

ST elevation may reflect dyskinesia without ischemia in canines; leaves open human relevance and requires clinical validation.

Structured PICO

Does regional ventricular dyskinesia induced by negative inotropic agents cause ST-segment elevation in the absence of myocardial ischemia in canine hearts?

P
Population
33 anesthetized open-chest dogs undergoing intracoronary injection of negative inotropic agents to induce regional ventricular dyskinesia.
I
Intervention
Intracoronary injection of negative inotropic agents (lidocaine 1-4 mg, nicorandil 100-400 μg, propranolol 0.25-1.0 mg, or verapamil 30-120 μg) into the left anterior descending coronary artery during maximal vasodilation induced by adenosine
C
Comparator
Intracoronary injection of nitroglycerin (20-80 μg) or normal saline (vehicle)
O
Outcome
ST-segment elevation and regional myocardial contraction (percent systolic shortening and percent systolic bulging)surrogate

Regional ventricular dyskinesia (systolic bulging) can directly cause ST-segment elevation in the absence of myocardial ischemia, suggesting ST-segment elevation is not always a specific marker for acute ischemia.

Limitations

  • More detailed investigations at the cellular and single-channel level are needed to clarify the mechanoelectrical feedback mechanisms.

Cite This Study

Shimada et al. (1999) studied Regional ventricular dyskinesia and ST-segment elevation (n=33). Negative inotropic agents (lidocaine, nicorandil, propranolol, or verapamil) was evaluated on ST-segment elevation and regional myocardial contraction (% systolic shortening and % systolic bulging). Intracoronary injection of negative inotropic agents induced dose-dependent ST-segment elevation associated with a parallel reduction in systolic shortening and increase in systolic bulging.

synapsesocial.com/papers/6a99d13f0c3d7640c6fdff55https://doi.org/10.1253/jcj.63.610

Topics

Women and heart disease
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Role of ATP-sensitive K+ channel on ECG ST segment elevation during a bout of myocardial ischemia. A study on epicardial mapping in dogs.1993 · 85 citations
  2. 2Oxygen requirements of the dyskinetic myocardial segment1989 · 37 citations
  3. 3Stretch-induced depolarizations as a trigger of arrhythmias in isolated canine left ventricles1992 · 100 citations
  4. 4Analysis of systolic bulging. Mechanical characteristics of acutely ischemic myocardium in the conscious dog.1986 · 91 citations
  5. 5Pinacidil-induced electrical heterogeneity and extrasystolic activity in canine ventricular tissues. Does activation of ATP-regulated potassium current promote phase 2 reentry?1993 · 154 citations