Qualitative and quantitative analysis of characteristic body surface potential map features in anterior and inferior myocardial infarction

Kornreich, Frédéric; Montague, Terrence J.; Kavadias, Michail; Segers, Jérôme; Rautaharju, Pentti M.; Horacek, Milan; Taccardi, Bruno

doi:10.1016/0002-9149(87)90600-x

Cited by 30 publications

(20 citation statements)

References 26 publications

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“…HRV is profoundly affected by many factors such as prior myocardial infarction [8, 12, 13], congestive heart failure [14, 15], diabetes [16, 17]and cardiovascular drugs [18, 19, 20, 21, 22, 23]. It is not known if uncomplicated coronary artery disease per se is associated with changes of HRV, as all studies addressing that question included patients with prior MI, congestive heart failure, diabetes or on β-blockers [5, 6, 7].…”

Section: Discussionmentioning

confidence: 99%

Reduced Heart Rate Variability in Ischemic Heart Disease Is Only Partially Caused by Ischemia

et al. 2000

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Background: Reduced heart rate variability (HRV) after acute myocardial infarction (AMI) indicates poor prognosis. HRV in patients with uncomplicated coronary artery disease is reduced, and an association with poor prognosis has been suggested. The mechanism of the HRV reduction is not known, but ischemia is a possibility. Aim: To evaluate, in angina patients with no prior AMI, no other disease and drug-free, if complete revascularization and thus important reduction of ischemia by means of PTCA influences HRV. Patients and Methods: Twenty-four-hour Holter recordings were performed at baseline prior to PTCA in 48 patients with angina and in 41 age-matched healthy control subjects. The recording was repeated 1 and 6 months after complete revascularization. In addition, HRV was registered during controlled respiration in the supine and standing positions and during cold pressure test at baseline in all angina patients and controls and in 17 consecutive angina patients 6 months after PTCA. Results: Compared to controls, angina patients had a significantly reduced mean RR interval (p = 0.02), SD (p = 0.003), rMSSD (p = 0.03), pNN50 (p = 0.03), total power (p = 0.003), low- (p = 0.004) and high-frequency peak (p = 0.04), but normal SDNN, SDANN and LF/HF. One and 6 months after PTCA, 42/46 and 32/40 follow-up patients, respectively, were free of angina. Six months after PTCA, there was a significant recovery of vagal modulation seen in the frequency domain during controlled respiration, but only nonsignificant trends in HRV parameters analyzed over 24 h. Conclusion: Patients with uncomplicated angina had reduced HRV, mainly affecting vagal activity, but normal low frequency variability associated with mortality. Complete revascularization caused a partial normalization of vagal modulation indicating that ischemia may be one of but not the only mechanism of the HRV reduction in uncomplicated chronic coronary artery disease.

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Section: Discussionmentioning

confidence: 99%

Reduced Heart Rate Variability in Ischemic Heart Disease Is Only Partially Caused by Ischemia

et al. 2000

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“…Although several techniques, including the 12-lead electrocardiogram (ECG), body surface mapping (BSM), measurement of released serum myocardial enzymes, and single-photon emission computed tomography of myocardium (SPECT), have been proposed; they are not very satisfactory in clinical settings because of limitations such as low accuracy of ECGs, complexity of BSM, high cost of and radiation produced by SPECT, and repeated blood samplings and the length of time required for biochemical measurement. [6][7][8][9][10] Vectorcardiography (VCG) has been showed to be superior to ECG for the diagnosis of MI in that it can provide more detailed spatial information, and it has recently been used to estimate the myocardium at risk and the final infarct size. [11][12][13][14][15] However, like BSM, there is a variety of individual difference, and, the more information it contains, the more difficult it is to explain the results correctly, especially in the situation of quantitative analysis.…”

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confidence: 99%

Vectorcardiographic Evaluation of Myocardial Infarct Size

et al. 1998

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yocardial infarct size has been proved to be closely associated with the occurrence of serious ventricular arrhythmia, the recovery of left ventricular function, and, consequently, the mortality rate of myocardial infarction (MI) 1,2 Accordingly, the management of acute MI has focused on reducing myocardial infarct size, and many methods such as thrombolytic therapy and various kinds of invasive revascularization have been shown to be effective in limiting infarct size and as a result improving both short-and long-term survival. [3][4][5] To evaluate the effects of treatment and to predict the prognosis of the patients, it is essential to establish an easy and accurate method of assessing infarct size for clinical application. Although several techniques, including the 12-lead electrocardiogram (ECG), body surface mapping (BSM), measurement of released serum myocardial enzymes, and single-photon emission computed tomography of myocardium (SPECT), have been proposed; they are not very satisfactory in clinical settings because of limitations such as low accuracy of ECGs, complexity of BSM, high cost of and radiation produced by SPECT, and repeated blood samplings and the length of time required for biochemical measurement. 6-10 Vectorcardiography (VCG) has been showed to be superior to ECG for the diagnosis of MI in that it can provide more detailed spatial information, and it has recently been used to estimate the myocardium at risk and the final infarct size. 11-15 However, like BSM, there is a variety of individual difference, and, the more information it contains, the more difficult it is to explain the results correctly, especially in the situation of quantitative analysis. Therefore, in the present study, a "departure loop" was made from MI patients' and normal subjects' VCGs, and we sought to determine whether the departure parameters derived from the departure loop were more accurate than the conventional spatial parameters for evaluating myocardial infarct size. Methods SubjectsThe study population consisted of 74 patients (66 men and 8 women with a mean age of 61.7±11.4 years). All patients were suffering from acute MI for the first time, and the diagnosis of MI was established from the ECG findings, peak creatime kinase (CK)-MB, echocardiography, and coronary artery angiography (CAG). VCG examination was performed 28. To determine whether the departure parameters derived from a "departure loop" of a vectorcardiogram are more accurate than conventional spatial parameters in evaluating myocardial infarct size, 74 patients with first-onset myocardial infarction (MI) were studied. The correlation between the departure parameters (amplitudes in scalar leads of the departure loop) and the percent defect volume of thallium myocardial scintigrams (%DV) was compared with that of the spatial parameters (magnitude, azimuth, and elevation of the original QRS loop). In anteroseptal MI, the amplitude of a 20-msec vector in the z-axis and the azimuth of a 30-msec vector (H30) were significantly correlated with %DV (r=...

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“…Location and size of myocardial infarction has been determined from isointegral analysis of BSPM maps [129] as well as analysis of maps of abnormal Q waves and changes in ST elevation [6]. These findings have allowed an improvement in diagnosis of anterior and inferior AMI with discriminant analysis [73,74] and later other infarction locations [97] even when associated with additional complications such as bundle branch block (BBB) [95,94]. Diagnosis of AMI is improved by the use of BSPM with an overall sensitivity of 80 per cent compared to 57 per cent with the standard ECG [103].…”

Section: Body Surface Potential Mappingmentioning

confidence: 99%

“…Kornreich et al proposed to select optimum lead sets from BSPM recordings by determining the leads that showed the greatest statistically significant signal difference for separating data from diagnostic group pairs [73,76,74].…”

Section: Discriminant Analysis Approachmentioning

confidence: 99%

“…These discriminant maps were mostly used to discriminate between healthy subjects and myocardial infarction patients [73,74] or ventricular hypertrophy patients [76]. Discriminant indexes for each electrode site and each group comparison were obtained by further dividing each resulting difference by the composite standard deviation computed from the population under consideration.…”

Section: Discriminant Analysis Approachmentioning

confidence: 99%

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Activation patterns in atrial fibrillation: contributions of body surface potential mapping.

Sanchez¹,

Salud²

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A mi padre AgradecimientosQuiero expresar mi agradecimiento a todas las personas que me han apoyado durante la realización de esta tesis doctoral y que han sido muchas.A mi madre y a mi tía, que no sólo me han apoyado anímicamente durante la realización de esta tesis, sino que sin su ayuda, aguja e hilo en mano, sus ideas y su trabajo ni siquiera hubiera podido comenzar a desarrollar esta tesis.A mis directores de tesis Pepe Millet y Paco Castells. A Pepe quiero agradecerle la confianza que siempre ha depositado en mí y el haberme apoyado siempre en todo lo que le ha sido posible durante estos anos. A Paco quiero agradecerle su ayuda durante laúltima etapa de la realización de la tesis y especialmente su meticulosidad en la redacción científica que tanto ha mejorado la calidad de mi trabajo.A los doctores Javier Chorro y Vicent Bodí del Hospital Clínico Universitario de Valencia. Ellos fueron los primeros en dedicarme su tiempo y permitirme tomar registros en su consulta con la ayuda de los entonces residentes Mauricio Pellicer y Lorena Peiró.Al doctor Steven Swiryn y al profesor Alan Sahakian por haberme permitido trabajar con ellos en su grupo en la Northwestern University en EEUU. Ellos supieron transmitirme su dinamismo, su entrega a la investigación y de ellos he aprendido cómo poner en práctica el método científico desde la planificación del trabajo hasta la presentación de resultados.Al doctor Andreas Bollmann y a la doctora Daniela Husser del Hospital de Leipzig en Alemania por haber creído en mi proyecto y haberse involucrado activamente en mi investigación desde la toma registros a los pacientes de su hospital al diseno de los estudios o colaboración en la difusión de resultados.Al doctor Aurelio Quesada del Hospital General de Valencia con quien estamos colaborando actualmente poniendo en práctica los métodos desarrollados en esta tesis. Conél, además de llevar a cabo proyectos muy prometedores, es todo un placer colaborar gracias a su inquietud científica y a su calidad humana.Al doctor Ramón Brugada, con el que he tenido el honor poder colaborar y con el que espero poder tener el honor de seguir colaborando en el futuro. Coń el no sólo estoy teniendo la posibilidad de realizar investigación puntera en el campo de la cardiología, sino que también he tenido la oportunidad de conocer iii iv AGRADECIMIENTOS a un científico ejemplar y una persona excepcional.A los pacientes y voluntarios que han participado en los estudios que han dado lugar a esta tesis y que han tenido que soportar con paciencia que les llenara el cuerpo de cables y cintas de una forma totalmente desinteresada. Sin ellos no me hubiera sido posible desarrollar esta tesis.A los que han sido mis companeros de laboratorio desde que empecé a interesarme por la investigación durante la realización de mi proyecto final de carrera y que tanto me animaron en los momentos difíciles: Fili, Pepelu, Natalia, Diego, Cibeles, Robin, Vicente, David, Laura, José Antonio y también a todos los que han formado parte del grupo de investigación durante todo...

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Qualitative and quantitative analysis of characteristic body surface potential map features in anterior and inferior myocardial infarction

Cited by 30 publications

References 26 publications

Reduced Heart Rate Variability in Ischemic Heart Disease Is Only Partially Caused by Ischemia

Reduced Heart Rate Variability in Ischemic Heart Disease Is Only Partially Caused by Ischemia

Vectorcardiographic Evaluation of Myocardial Infarct Size

Activation patterns in atrial fibrillation: contributions of body surface potential mapping.

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