Ischaemia persistent

When acute coronary occlusion is carried out in experimental animals with closed thorax, it gives rise, during the initial phase of ischaemia, to a delay in repolarisation (TAP) in the subendocardium, which is the area that first suffers ischaemia (Lengyel et al, 1957). This subendocardial ischaemia is evidenced by a tall and peaked T wave immediately followed by ST-segment elevation (injury pattern) if the occlusion persists and the ischaemia becomes severe and transmural (see ECG pattern of injury p. 55). This pattern maybe self-limited if the occlusion is temporary, as in coronary spasm (Prinzmetal... 

We should remember that in some chronic coronary patients, those who present a transmural infarction classically named inferoposterior but with the new classification we define as inferolateral MI (Figure 5.9B(3)), a tall, frequently peaked, and in this case persistent, T wave may be recorded in V1-V3 as a consequence of the changes that the transmural infarction produced in repolarization (mirror pattern of inferobasal and lateral subepicardial ischaemia) (Figure 3.10). 

According to the membrane response curve (Singer and Ten Eick, 1971) (Figure 4.4), the area with significant and persistent ischaemia shows... 

In human beings, the electrocardiographic injury pattern is seen in the presence of evident and persistent clinical ischaemia. When we extrapolate the findings in the experimental field to clinical practice, it could be considered that when the ischaemia is important, persistent and predominant in a certain area (subendocardium or subepi-cardium), an evident diastolic depolarisation in that area generates a low-quality TAP (slower... 

The typical pattern of evolving STE-ACS represents the presence of persistent (>30 min) ST-segment elevationf and expresses the successive phenomena that occur during a complete occlusion of an epi-cardial artery CMR has demonstrated (Mahrhold et al, 2005) that the wavefront of ischaemia and consequent infarction begin in the subendocardium and grow towards the epicardium over the next... 

Forebrain ischaemia (5 min) increased NADH and decreased flavoprotein signals in all hippocampal areas of the gerbil, but reduction in mitochondrial redox ratio was greater in CAl than in other areas of the hippocampus (Shiino et al. 1999). Immediately after recirculation, mitochondrial redox ratio recovery was delayed in the CAl and the dentate gyrus, and the reduction in mitochondrial redox ratio persisted in CAl. 

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