دورية أكاديمية
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Is ischemic stimulus involved for J wave augmentation during coronary angiography and intracoronary administration of normal saline?

التفاصيل البيبلوغرافية
العنوان: Is ischemic stimulus involved for J wave augmentation during coronary angiography and intracoronary administration of normal saline?
المؤلفون: Nakayama M; Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan.; Department of Cardiology, Tokyo D Tower Hospital, Tokyo, Japan., Matsuo H; Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan., Sato T; Department of Cardiology, Tachikawa General Hospital, Nagaoka, Japan., Okabe M; Department of Cardiology, Tachikawa General Hospital, Nagaoka, Japan., Aizawa Y; Research and Development Division, Tachikawa Medical Center, Nagaoka, Japan.
المصدر: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2024 Aug; Vol. 47 (8), pp. 1065-1072. Date of Electronic Publication: 2024 Jun 09.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Futura Pub. Co. Country of Publication: United States NLM ID: 7803944 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8159 (Electronic) Linking ISSN: 01478389 NLM ISO Abbreviation: Pacing Clin Electrophysiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Mount Kisco, N. Y. : Futura Pub. Co., c1978-
مواضيع طبية MeSH: Coronary Angiography* , Myocardial Ischemia*/physiopathology , Myocardial Ischemia*/diagnostic imaging , Electrocardiography* , Saline Solution*/administration & dosage, Humans ; Male ; Female ; Middle Aged ; Aged ; Injections, Intra-Arterial
مستخلص: Background: J waves may be augmented by coronary angiography (CAG) or intracoronary drug administration but the underlying mechanism is unknown.
Purpose: The effect of intracoronary normal saline (NS) on J waves were investigated.
Patients and Methods: After the standard CAG using iopamidol (Iopamiro R Inj), NS was injected into the right coronary artery in 10 patients with and eight patients without J waves at the baseline. The 12-lead ECG was monitored, stored on a computer and retrieved later for measurement of the J wave amplitude before or during the coronary interventions.
Results: J waves in leads II, III and aVF at baseline increased significantly in each lead during the right CAG and NS injection into the right coronary artery. The J wave changes were similar between the two interventions and distinct similar alterations were observed in the QRS complex. We postulated that the ischemic myocardium that was induced during CAG or intracoronary NS administration slowed the conduction velocity of depolarization in the perfusion territory and delayed the timing of J waves to appear. Then, the delayed appearance of J waves would be less opposed by electromotive force from other areas resulting in augmentation.
Conclusion: J wave augmentation was observed during CAG and intracoronary NS administration. As a mechanism of augmentation, we postulated that contrast media and NS induce myocardial ischemia and delay the timing of J waves to a point of less opposition by electromotive force from other areas.
Highlights: J wave augmentation has been reported during intracoronary injection of contrast media or drugs. The present study confirmed that normal saline alone was able to augment J waves. Mechanistically, coronary interventions using anoxic solutions can cause regional myocardial ischemia and reduce the conduction velocity of depolarization. Then, delayed J waves are less opposed by the electromotive force from remote areas which leads to augmentation. When a drug is diluted in normal saline and given intracoronarily, changes in J waves can be due to normal saline. The pathophysiological and clinical significance of J waves augmented during coronary interventions need to be established.
(© 2024 Wiley Periodicals LLC.)
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فهرسة مساهمة: Keywords: augmentation of J waves; conduction delay; contrast medium; myocardial ischemia; normal saline
المشرفين على المادة: 0 (Saline Solution)
تواريخ الأحداث: Date Created: 20240609 Date Completed: 20240806 Latest Revision: 20240806
رمز التحديث: 20240806
DOI: 10.1111/pace.15005
PMID: 38852066
قاعدة البيانات: MEDLINE
الوصف
تدمد:1540-8159
DOI:10.1111/pace.15005