Abstract: [Abstract] Objective To study the alteration of transmural dispersion of repolarization (TDR) and its relationship to ventricular arrhythmia or automatic nerve system dysfunction in patients with ST segment elevated acute myocardial infarction. Method 129 STE-AMI cases which were not capable being revascularized(AMI group) and 36 cases of control(control group) were enrolled randomizedly. The values corrected TDR(TDRc) between AMI and control groups, and TDRc recorded at the time point of in-charged, the 2th day and the 3th day were compared. The correlationship between standard deviation of NN intervals (SDNN) and TDRc were probed; Patients in AMI group were divided into malignant ventricular arrhythmia(MVA) group and non-MVA group according to Holter outcomes, and the TDRc of the 2 groups were also compared. Result (1) TDRc of AMI group was much higher than the corresponding values in control group (P<0.001), whereas there was no remarked difference among the TDRc values at different time-points of AMI group(P>0.05).(2) Significant negative correlationship was found between TDRc and SDNN in AMI group(r=-0.258, P< 0.05);(3) TDRc of MVA group was higher than those in non-MVA group(P<0.01).(4) there were 2 cases who died of ventricular febrilation in MVA group while no dead occurred on non-MVA group. Conclusion TDRs of STE-AMI cases are significantly elevated and sustain a high-level during the first 3 days at least; In comparison with non-MVA group, the MVA group was demonstrated with higher TDRc and cardiovascular risk; The automatic nerve system may contribute to the enlargement of TDR of non-AMI patients.

Key words: acute myocardial infarction, ST segment elevation, ventricular arrhythmia, transmural dispersion of repolarization