Ionic mechanisms of ST segment elevation in electrocardiogram during acute myocardial infarction.

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 (IK_ATP) 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 IK_ATP 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 g

SUBMITTER: Okada JI 

PROVIDER: S-EPMC10717899 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature