Electrocardiographic Recognition of Unprotected Left Main ST-Segment Elevation Myocardial Infarction

González-Bravo, Diego H.; Escabí-Mendoza, José

doi:10.1016/j.jaccas.2021.02.014

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…The first is the cardiac ultrasound, which is also known as color Doppler echocardiography; in the diagnosis of patients first by using an ultrasound probe to scan the patient's chest, which in turn can obtain images of heart sections in different directions of the same patient's heart, and not only that, the operator can also obtain parameters related to the patient's heart function through the device, and in combination with the above images and based on these images and parameters, a comprehensive evaluation of the patient's heart can be performed to determine whether there are any abnormalities in the heart function and to provide a reference basis for the subsequent treatment [11]. After obtaining an ultrasound image of the heart, the clinician can also analyze in detail whether the blood flow distribution in the heart is normal and whether the echogenic signal of the heart is within a reasonable range to obtain a comprehensive assessment of the patient's heart function [12]. Among them, cardiac ultrasound not only helps physicians to determine the patient's condition more rationally but also to determine more accurately whether there is myocardial insufficiency and other complications caused by myocardial problems in the patient's heart.…”

Section: Background Of the Studymentioning

confidence: 99%

Deep Learning-Based ECG Abnormality Identification Prediction and Analysis

Liang

2022

Journal of Sensors

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In recent years, China’s economy has been developing rapidly, and people’s life and quality of life have been improving; more importantly, people’s habits and living habits have also developed from the previous “unhygienic” and “not very careful” to the current “Healthier, more hygienic, greener and more sophisticated” direction. In the process of this development, due to the rapid development of the economy and the industrialization of cities, the incidence of heart disease is also increasing year by year. According to relevant studies, China’s urbanization process has been unprecedented, the number of urbanized people in China has exploded in recent years, and the ratio of urban to rural population has increased from about 20 percent to about 75 percent today. The effects of the population and the urbanization of urban architecture are affecting people’s physical and mental health, both consciously and unconsciously, causing both positive and negative physical and mental effects on the psychological and physical levels. In this paper, the concept of deep learning is fully utilized to train the CNN neural network model and apply it to the ECG abnormality recognition and prediction examination. In order to fully validate the application and significance of deep learning in ECG abnormality identification and prediction, the whole project was completed through subjective and objective experiments. The experimental results show that, from the subjective aspect, the ECG examination has been accepted by most people for different age groups, and the analysis results of the ECG examination with the deep learning model in this paper are more satisfactory; from the objective aspect, the CNN-ECG abnormality recognition prediction network model trained in this paper has high. The accuracy of the model for ECG abnormality recognition prediction can reach 86% when the learning rate is set to 0.0001 and the batch size is set to 120, and the model can reduce the burden of medical personnel to a certain extent.

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Section: Background Of the Studymentioning

confidence: 99%

Deep Learning-Based ECG Abnormality Identification Prediction and Analysis

Liang

2022

Journal of Sensors

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“…A previous study demonstrated that simultaneous LAD + LCX occlusion damped the STE induced by single LAD occlusion in leads V1 in a swine model ( 23 ). Several cases of LM occlusion have described this STEMI pattern resembling pLAD occlusion, with STE in the precordial leads V2–V5 but not in V1 ( 24 – 27 ). The current study is the first to demonstrate that STE in the precordial leads from V2–V5, without V1, is a specific predictor for distinguishing LM and LAD occlusion.…”

Section: Discussionmentioning

confidence: 96%

Combining electrocardiographic criteria for predicting acute total left main coronary artery occlusion

Liu

Yang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundPrediction of left main artery (LM) occlusion may contribute to the administration of early reperfusion. We sought to identify electrocardiographic (ECG) features associated with acute total LM occlusion and explore the relationship between ECG features and collateral circulation.MethodsWe retrospectively studied ECGs in 84 consecutive patients with LM occlusion between January 2001 and April 2022. The ECG findings in these patients were compared with those in 468 consecutive patients with LM subtotal occlusion and non-LM occlusion.ResultsThree main ECG patterns were described according to the characteristics of ST elevation (STE) in LM occlusion: ST-segment elevation myocardial infarction (STEMI), STE in aVR with diffuse ST depression, and STE in both aVR and aVL. These ECG patterns were associated with different collateral filling territories. One-third STEMI in LM occlusion showed STE in the precordial leads including V1, while 2/3 STEMI showed STE in the precordial leads from V2 to V5 without STE in V1. The following ECG characteristics predicted LM occlusion: STE in both aVR and aVL; STE in I, aVL, and V2–V5 without V1; left anterior fascicular block (LAFB); right bundle branch block (RBBB) + LAFB; and prolongation of the QRS interval. The incidences of STE in aVR and STE in aVR and V1 were higher in LM subtotal occlusion than in LM occlusion. The combination of two different STE criteria (STE in aVR and aVL and STE in I, aVL, V2-V5 without V1) predicted LM occlusion with 62% sensitivity and 95% specificity. The combination of the STE criteria and fascicular block criteria (LAFB and LAFB + RBBB) further improved the specificity to 99% but reduced the sensitivity to 39%.ConclusionThe combination of STE criteria predicted LM occlusion with high specificity and moderate sensitivity, and the addition of fascicular block criteria further improved the specificity with some loss of sensitivity.

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“…5 Because cardiovascular mortality in STEMI caused by unprotected LMT lesions remains high (60%-90%), often resulting in cardiogenic shock or sudden cardiac death, earlier diagnosis and medical intervention is required to improve patients' survival rate. 6 Yamaji et al 7 reported that ST-segment elevation in lead aVR with less ST-segment elevation in lead V 1 is an important predictor of acute LMT obstruction. Fujii et al 8 reported that a larger magnitude of ST-segment depression in lead II than the magnitude of ST-segment elevation in lead V 2 and ST-segment depression in lead V 5 are proposed as identifiable distinctive criteria for STEMI due to LMT lesion.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported that the incidence of STEMI caused by LMT ranged from 0.58% to 2.5% in patients undergoing cardiac catheterization . Because cardiovascular mortality in STEMI caused by unprotected LMT lesions remains high (60%-90%), often resulting in cardiogenic shock or sudden cardiac death, earlier diagnosis and medical intervention is required to improve patients’ survival rate . Yamaji et al reported that ST-segment elevation in lead aVR with less ST-segment elevation in lead V 1 is an important predictor of acute LMT obstruction.…”

Section: Discussionmentioning

confidence: 99%