American Journal of Cardiology
Volume 77, Issue 4 , Pages 237-241, 1 February 1996

Effects of antioxidant vitamins C and E on signal-averaged electrocardiogram in acute myocardial infarction

  • Tomasz Chamiec, MD

      Affiliations

    • Corresponding Author InformationAddress for reprints: Tomasz Chamiec, MD, Department of Cardiology, Grochowski Hospital, 51/59 Grenadierów Street, 04-073 Warsaw, Poland.
    • From the Department of Cardiology, Postgraduate Medical School, Grochowski Hospital Poland
    • From the Medical Research Center, Polish Academy of Sciences, Warsaw, Poland
    • ,
  • Krystyna Herbaczyńska-Cedro, MD, PhD

      Affiliations

    • From the Department of Cardiology, Postgraduate Medical School, Grochowski Hospital Poland
    • From the Medical Research Center, Polish Academy of Sciences, Warsaw, Poland
    • ,
  • Leszek Ceremużyński, MD, PhD

      Affiliations

    • From the Department of Cardiology, Postgraduate Medical School, Grochowski Hospital Poland
    • From the Medical Research Center, Polish Academy of Sciences, Warsaw, Poland

Received 29 June 1995; accepted 3 October 1995.

with the technical assistance of Beata Klosiewicz-Wasek, MD and Wojciech Wasek, MD

Abstract 

Experimental studies indicate that oxygen-free radicals contribute to ischemic myocardial damage and affect electric properties of cellular membranes. We hypothesize that an association exists between an oxygen-free radical-induced component of myocardial ischemic injury and altered electric function that underlies the genesis of ventricular late potentials in the course of myocardial infarction. If so, antioxidant vitamins C and E may prevent alterations in the signal-averaged electrocardiogram (SAECG). To test this hypothesis, we investigated the effect of supplementation with vitamins C and E on the indices of the SAECG in patients with acute myocardial infarction (AMI). Sixty-one patients with AMI were randomized to receive conventional treatment and vitamins C and E, each 600 mg/day, orally for 14 days (supplemented group, n = 33) or conventional treatment only (control group, n = 28). SAECG was recorded on days 1 or 2 and between days 9 and 13 (mean 10). Serum ascorbic acid, tocopherol, plasma lipid peroxides, and oxygen-free radical production by isolated leukocytes were measured on days 1 or 2 and between days 12 and 14. In the control group, SAECG showed an increase in mean QRS and low-amplitude (<40 μV) signal durations, from 99 ± 10 to 111 ± 13 ms (p < 0.001) and from 31 ± 8 to 38 ± 10 ms (p < 0.001), respectively, and a decrease in the root-mean-square voltage of the last 40 ms of the QRS complex, from 36 ± 25 to 21 ± 11 μV (p < 0.002). In vitamin-supplemented patients, all these indices remained unchanged. Oxygen-free radical production by isolated leukocytes was decreased compared with that in controls (p < 0.02). Supplementation was confirmed by elevation of serum ascorbic acid and tocopherol. Results support the hypothesis that in patients with AMI, oxygen-free radical-induced cellular damage contributes to alterations in electric function of the heart as seen on the SAECG.

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PII: S0002-9149(97)89385-X

American Journal of Cardiology
Volume 77, Issue 4 , Pages 237-241, 1 February 1996

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