gms | German Medical Science

Background: The description and basing of the noninfarction areas syndrome with overtired myocardium phenomenon were performed; its study’s outlook and possibility of practical use were determined. The syndrome’s essence is the development of ischemic changes of myocardium in various degrees in noninfarction areas in patients with myocardial infarction (MI).

Methods: The ECG mapping has been made in 19 patients with MI. The ∑ST, ∑Q, ∑R and ∑T dynamics in the MI area and in noninfarction areas since the 1st day up to the 20th one have been analyzed. All patients were divided into two main groups: with recurrent (group 1) and primary MI (group 2). The last one was combined with initial level of general cholesterol 8.19±0.44 mmol/l (2A) and 5.9±0.24 mmol/l (2B) (p<0.001).

Results and discussion: By ECG mapping method the injury and necrosis of cardiomyocytes were defined in noninfarction areas. These changes were developed gradually during the disease and were principally of diffuse character. The course of recurrent MI differs from the course of primary one by less lesion of myocardium in MI zone and greater lesion in noninfarction region. It was the direct proportionality between the degree of pathological changes in both areas and initial level of general cholesterol in patients with the primary MI.

Conclusion: The clinical estimation of changes in noninfarction areas of myocardium has been presented as a new ischemic syndrome. Such approach allows explaining a number of morphological and clinical phenomena (hibernation, the heart remodeling, the forming of ischemic cardiomyopathy, etc.), which determine peculiarities of further course of MI and ischemic heart disease in the post-infarction period including the pathogenesis of heart failure.