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ST-segment changes in high-resolution body surface potential maps measured during exercise to assess myocardial ischemia: a pilot study.

Kania M, Zaczek R, Zavala-Fernandez H, Janusek D, Kobylecka M, Królicki L, Opolski G, Maniewski R - Arch Med Sci (2014)

Bottom Line: The maps of ST-segment depression (ST60) were calculated from time averaged recordings at rest and at maximal workload.The efficiency in detection of myocardial ischemia was higher for HR-BSPM than for standard 12-lead electrocardiography (ECG) when both methods were evaluated by outcomes of coronarography.For some patients significant changes in the ST segment were observed at stress HR-BSPM but were not visible in standard 12-lead ECG recorded under the same conditions.

View Article: PubMed Central - PubMed

Affiliation: Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.

ABSTRACT

Introduction: The aim of the study was to assess myocardial ischemia by analysis of ST-segment changes in high-resolution body surface potential maps (HR-BSPM) measured at rest and during an exercise stress test.

Material and methods: The study was carried out on a group of 28 patients with stable coronary artery disease and 15 healthy volunteers. The HR-BSPM were measured at rest and during the exercise stress test on a supine ergometer. The workload was increased in stages by 25 W every 2 min, beginning at 50 W. The maps of ST-segment depression (ST60) were calculated from time averaged recordings at rest and at maximal workload.

Results: The efficiency in detection of myocardial ischemia was higher for HR-BSPM than for standard 12-lead electrocardiography (ECG) when both methods were evaluated by outcomes of coronarography. The sensitivity of HR-BSPM was 82.4% while for the standard 12-lead ECG exercise stress test it was 58.8%. For some patients significant changes in the ST segment were observed at stress HR-BSPM but were not visible in standard 12-lead ECG recorded under the same conditions.

Conclusions: Obtained high values of sensitivity and specificity in myocardial ischemia detection suggest that maps of ST60 calculated from HR-BSPM can improve detection of patients with ischemic heart disease in comparison to the standard electrocardiographic exercise stress test examinations.

No MeSH data available.


Related in: MedlinePlus

Body surface maps of ST-segment amplitude 60 ms after J point computed from averaged in time multilead ECG recordings of patients with stable coronary artery disease (A, B) and healthy volunteer (C). The significant (A) and non-significant (B, C) ST-segment changes in BSPM due to exercise are shown. Presented maps were obtained from ECG signals recorded at rest and at maximal effort. The patients had ischemia detected by coronarography and additionally by SPECT examination but not in a standard 12-lead ECG stress test
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Figure 0002: Body surface maps of ST-segment amplitude 60 ms after J point computed from averaged in time multilead ECG recordings of patients with stable coronary artery disease (A, B) and healthy volunteer (C). The significant (A) and non-significant (B, C) ST-segment changes in BSPM due to exercise are shown. Presented maps were obtained from ECG signals recorded at rest and at maximal effort. The patients had ischemia detected by coronarography and additionally by SPECT examination but not in a standard 12-lead ECG stress test

Mentions: The results of the study are presented in Table II and Figure 2. The representative distributions of ST60 values on the thorax surface for one healthy volunteer as well as for two patients with and without significant exercise-induced changes in the ST segment are shown in Figure 2. The reference maps of ST-segment amplitude computed from rest ECG recordings and ST60 values observed during maximal effort are presented. The red (blue) color corresponds to the maximum (minimum) ST60 values calculated from all ECG lead positions. The patients for which the significant changes of ST60 in HR-BSPM maps were shown in Figures 2A and 2B had ischemia detected in coronarography but not in standard 12-lead ECG. The additional performed SPECT studies confirmed ischemia detection for these 2 patients.


ST-segment changes in high-resolution body surface potential maps measured during exercise to assess myocardial ischemia: a pilot study.

Kania M, Zaczek R, Zavala-Fernandez H, Janusek D, Kobylecka M, Królicki L, Opolski G, Maniewski R - Arch Med Sci (2014)

Body surface maps of ST-segment amplitude 60 ms after J point computed from averaged in time multilead ECG recordings of patients with stable coronary artery disease (A, B) and healthy volunteer (C). The significant (A) and non-significant (B, C) ST-segment changes in BSPM due to exercise are shown. Presented maps were obtained from ECG signals recorded at rest and at maximal effort. The patients had ischemia detected by coronarography and additionally by SPECT examination but not in a standard 12-lead ECG stress test
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296061&req=5

Figure 0002: Body surface maps of ST-segment amplitude 60 ms after J point computed from averaged in time multilead ECG recordings of patients with stable coronary artery disease (A, B) and healthy volunteer (C). The significant (A) and non-significant (B, C) ST-segment changes in BSPM due to exercise are shown. Presented maps were obtained from ECG signals recorded at rest and at maximal effort. The patients had ischemia detected by coronarography and additionally by SPECT examination but not in a standard 12-lead ECG stress test
Mentions: The results of the study are presented in Table II and Figure 2. The representative distributions of ST60 values on the thorax surface for one healthy volunteer as well as for two patients with and without significant exercise-induced changes in the ST segment are shown in Figure 2. The reference maps of ST-segment amplitude computed from rest ECG recordings and ST60 values observed during maximal effort are presented. The red (blue) color corresponds to the maximum (minimum) ST60 values calculated from all ECG lead positions. The patients for which the significant changes of ST60 in HR-BSPM maps were shown in Figures 2A and 2B had ischemia detected in coronarography but not in standard 12-lead ECG. The additional performed SPECT studies confirmed ischemia detection for these 2 patients.

Bottom Line: The maps of ST-segment depression (ST60) were calculated from time averaged recordings at rest and at maximal workload.The efficiency in detection of myocardial ischemia was higher for HR-BSPM than for standard 12-lead electrocardiography (ECG) when both methods were evaluated by outcomes of coronarography.For some patients significant changes in the ST segment were observed at stress HR-BSPM but were not visible in standard 12-lead ECG recorded under the same conditions.

View Article: PubMed Central - PubMed

Affiliation: Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.

ABSTRACT

Introduction: The aim of the study was to assess myocardial ischemia by analysis of ST-segment changes in high-resolution body surface potential maps (HR-BSPM) measured at rest and during an exercise stress test.

Material and methods: The study was carried out on a group of 28 patients with stable coronary artery disease and 15 healthy volunteers. The HR-BSPM were measured at rest and during the exercise stress test on a supine ergometer. The workload was increased in stages by 25 W every 2 min, beginning at 50 W. The maps of ST-segment depression (ST60) were calculated from time averaged recordings at rest and at maximal workload.

Results: The efficiency in detection of myocardial ischemia was higher for HR-BSPM than for standard 12-lead electrocardiography (ECG) when both methods were evaluated by outcomes of coronarography. The sensitivity of HR-BSPM was 82.4% while for the standard 12-lead ECG exercise stress test it was 58.8%. For some patients significant changes in the ST segment were observed at stress HR-BSPM but were not visible in standard 12-lead ECG recorded under the same conditions.

Conclusions: Obtained high values of sensitivity and specificity in myocardial ischemia detection suggest that maps of ST60 calculated from HR-BSPM can improve detection of patients with ischemic heart disease in comparison to the standard electrocardiographic exercise stress test examinations.

No MeSH data available.


Related in: MedlinePlus