PDF(Pubmed)
Abstract：
OBJECTIVE: Although electrical activity of the normal human heart is well characterized by the electrocardiogram, detailed insights into within-subject and between-subject variations of ventricular activation and recovery by noninvasive electroanatomic mapping are lacking. We characterized human epicardial activation and recovery within and between normal subjects using non-invasive electrocardiographic imaging (ECGI) as a basis to better understand pathology.
RESULTS: Epicardial activation and recovery were assessed by ECGI in 22 normal subjects, 4 subjects with bundle branch block (BBB) and 4 with long-QT syndrome (LQTS). We compared characteristics between the ventricles [left ventricle (LV) and right ventricle (RV)], sexes, and age groups (<50/≥50years). Pearson\'s correlation coefficient (CC) was used for within-subject and between-subject comparisons. Age of normal subjects averaged 49 ± 14 years, 6/22 were male, and no structural/electrical heart disease was present. The average activation time was longer in LV than in RV, but not different by sex or age. Electrical recovery was similar for the ventricles, but started earlier and was on average shorter in males. Median CCs of between-subject comparisons of the ECG signals, activation, and recovery patterns were 0.61, 0.32, and 0.19, respectively. Within-subject beat-to-beat comparisons yielded higher CCs (0.98, 0.89, and 0.82, respectively). Activation and/or recovery patterns of patients with BBB or LQTS contrasted significantly with those found in the normal population.
CONCLUSIONS: Activation and recovery patterns vary profoundly between normal subjects, but are stable individually beat to beat, with a male preponderance to shorter recovery. Individual characterization by ECGI at baseline serves as reference to better understand the emergence, progression, and treatment of electrical heart disease.
RESULTS: Epicardial activation and recovery were assessed by ECGI in 22 normal subjects, 4 subjects with bundle branch block (BBB) and 4 with long-QT syndrome (LQTS). We compared characteristics between the ventricles [left ventricle (LV) and right ventricle (RV)], sexes, and age groups (<50/≥50years). Pearson\'s correlation coefficient (CC) was used for within-subject and between-subject comparisons. Age of normal subjects averaged 49 ± 14 years, 6/22 were male, and no structural/electrical heart disease was present. The average activation time was longer in LV than in RV, but not different by sex or age. Electrical recovery was similar for the ventricles, but started earlier and was on average shorter in males. Median CCs of between-subject comparisons of the ECG signals, activation, and recovery patterns were 0.61, 0.32, and 0.19, respectively. Within-subject beat-to-beat comparisons yielded higher CCs (0.98, 0.89, and 0.82, respectively). Activation and/or recovery patterns of patients with BBB or LQTS contrasted significantly with those found in the normal population.
CONCLUSIONS: Activation and recovery patterns vary profoundly between normal subjects, but are stable individually beat to beat, with a male preponderance to shorter recovery. Individual characterization by ECGI at baseline serves as reference to better understand the emergence, progression, and treatment of electrical heart disease.
摘要：
目的：尽管正常人心脏的电活动通过心电图得到了很好的表征，缺乏通过非侵入性电解剖标测对受试者内部和受试者之间的心室激动和恢复变化的详细见解。我们使用非侵入性心电图成像（ECGI）作为更好地了解病理学的基础，对正常人体内和之间的人心外膜激活和恢复进行了表征。
结果：通过ECGI评估了22名正常人的心外膜激活和恢复，4例束支传导阻滞（BBB）和4例长QT综合征（LQTS）。我们比较了心室的特征[左心室（LV）和右心室（RV）]，性别,和年龄组（<50/≥50岁）。Pearson相关系数(CC)用于受试者内部和受试者之间的比较。正常人平均年龄49±14岁,6/22是男性，并且没有结构性/电性心脏病。LV的平均激活时间比RV长，但没有不同的性别或年龄。心室的电恢复情况相似，但开始较早，男性平均较短。ECG信号的受试者之间比较的中间CC，激活,和恢复模式分别为0.61、0.32和0.19。受试者内的搏动到搏动比较产生了更高的CC（分别为0.98、0.89和0.82）。BBB或LQTS患者的激活和/或恢复模式与正常人群中的激活和/或恢复模式形成显着对比。
结论：正常受试者之间的激活和恢复模式差异很大，但是稳定的个体被击败，男性优势较短的恢复。基线时ECGI的个体特征可作为更好地理解出现的参考，programming,和治疗电心脏病。
结果：通过ECGI评估了22名正常人的心外膜激活和恢复，4例束支传导阻滞（BBB）和4例长QT综合征（LQTS）。我们比较了心室的特征[左心室（LV）和右心室（RV）]，性别,和年龄组（<50/≥50岁）。Pearson相关系数(CC)用于受试者内部和受试者之间的比较。正常人平均年龄49±14岁,6/22是男性，并且没有结构性/电性心脏病。LV的平均激活时间比RV长，但没有不同的性别或年龄。心室的电恢复情况相似，但开始较早，男性平均较短。ECG信号的受试者之间比较的中间CC，激活,和恢复模式分别为0.61、0.32和0.19。受试者内的搏动到搏动比较产生了更高的CC（分别为0.98、0.89和0.82）。BBB或LQTS患者的激活和/或恢复模式与正常人群中的激活和/或恢复模式形成显着对比。
结论：正常受试者之间的激活和恢复模式差异很大，但是稳定的个体被击败，男性优势较短的恢复。基线时ECGI的个体特征可作为更好地理解出现的参考，programming,和治疗电心脏病。
