Influence of Size and Location of Myocardial Infarction on TCRT parameter: A Computer Simulation Study

Electrocardiographic (ECG) parameter ´total cosine R-to-T´ (TCRT) has been shown to have remarkable prognostic value as a predictor of the outcomes of the coronary artery disease and the postmyocardial infarction patients. In this study, equivalent double layer (EDL) model was used to find action potential based causes to explain the observed diminution of the TCRT after myocardial infarction (MI). The model parameters affected the characteristics of QRS complex, ST segment and T wave. The size and the location of the MI were included in the model. The simulation results indicate that location of the infarction affects TCRT significantly. The trend, constituted by TCRT as function of the severity of the damage, differed significantly between the anterior and the inferior MI models. The values of the TCRT were lower in the case of anterior MI. Patient data (n=53) were used to confirm the results of the simulation: TCRT separated the anterior MI and inferior MI clearly (p<0.001). TCRT turned into negative values only in case of anterior MI. The results indicate that the location of the MI should be considered when interpreting changes of TCRT values with MI patients.