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Mechanisms of QRS Voltage Changes on ECG of Healthy Subjects during the Exercise Test

机译：运动试验中QRS电压变化对健康受试者心电图的影响机制

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Electrocardiography is the most commonly used technique for detection stress-induced myocar-dial ischemia. However, the sensitivity of ECG criteria is not high. One of the major problems is the difficulty in differentiating ECG changes caused by various factors. The aim of this study was to evaluate the dependence of the QRS voltage changes on ECG during exercise on the parameters of central hemodynamics, to analyze gender particularities, and to reveal the mechanisms causing these changes. To eliminate the effect of changes in cardiomyocyte transmembrane potentials under the influence of neurotransmitters of the auto-nomic nervous system during stepwise increasing exercises and/or due to adenosine triphosphate (ATP) deficiency resulting from inadequate myocardial blood flow, only apparently healthy subjects not older than 35 years (seven men and seven women) were involved in the study and only the periods of ventricular depolarization (QRS complex on ECG) were included in the analysis. We compared the changes of QRS waves during exercise sessions with two upper and one lower limb in both men and women. The moment of force developed during the exercise was twice greater in the exercise with one leg relative to the exercise with two arms. The responses of the heart rate and the systolic blood pressure were similar. The amplitude of the S-wave in the left precordial leads significantly increased in both sessions without significant difference between augmentations in the sessions and in groups of men and women. A significant dependence of the S-wave augmentation at the end of session and the peak systolic blood pressure was revealed. In addition, the QRS changes during the exercise with vertical and horizontal torso position were compared to assess the effect of diastolic blood pressure and displacement of the diaphragm and heart rotation due to an increase in the abdominal pressure during the last steps of exercise. The obtained results allow us to exclude the effect of changes in the heart position and size, as well as the exercise load on the revealed S-wave changes and to conclude that parameter depends on the systolic blood pressure.
机译：心电图检查是检测压力诱发的心肌缺血的最常用技术。但是，心电图标准的敏感性不高。主要问题之一是难以区分由各种因素引起的心电图变化。这项研究的目的是评估运动期间心电图QRS电压变化对中央血液动力学参数的依赖性，分析性别的特殊性，并揭示引起这些变化的机制。为了消除在逐步增加运动过程中和/或由于心肌血流不足引起的三磷酸腺苷（ATP）缺乏，在自主神经系统神经递质的影响下改变心肌细胞跨膜电位的影响，仅表面健康的受试者年龄不大研究涉及35岁以上（7名男性和7名女性），并且分析仅包括心室去极化（心电图上的QRS波）。我们比较了男性和女性在运动过程中QRS波在上肢和下肢的变化。在运动中，用一只腿进行锻炼的力矩比用两臂进行锻炼的力矩大两倍。心率和收缩压的反应相似。左心前区导联中的S波振幅在两个疗程中均显着增加，而在疗程中以及在男性和女性组之间的增加之间没有显着差异。会议结束时S波增强和收缩压峰值之间存在显着相关性。此外，比较了运动过程中躯干垂直和水平位置的QRS变化，以评估舒张压，and肌位移和运动的最后阶段由于腹部压力升高而引起的心脏旋转的影响。获得的结果使我们可以排除心脏位置和大小的变化以及运动负荷对显示的S波变化的影响，并得出结论，该参数取决于收缩压。

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