Vesterinen Paula, Hänninen Helena, Karvonen Milla, Lauerma Kirsi, Holmström Miia, Mäkijärvi Markku, Väänänen Heikki, Nenonen Jukka, Katila Toivo, Toivonen Lauri
Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland.
Ann Noninvasive Electrocardiol. 2004 Jul;9(3):234-42. doi: 10.1111/j.1542-474X.2004.93557.x.
We studied the ability of different time segments of the depolarization wave recorded with body surface potential mapping (BSPM) to detect and localize myocardial infarction (MI).
BSPM was recorded in 24 patients with remote MI and in 24 healthy controls. Cine and contrast-enhanced magnetic resonance imaging (MRI) was used as a reference method. Patients were grouped according to anatomical location of their MI. The QRS complex was divided into six temporally equal segments, for which time integrals were calculated.
The time segments of the QRS complex showed different MI detection capability depending on MI location. For anterior infarction the second segment of the QRS complex was the best in MI detection and the optimal area was on the right inferior quadrant of the thorax (time integral average -1.5 +/- 1.8 mVms patients, 1.0 +/- 1.6 mVms controls, P = 0.002). For lateral infarction the first segment of the QRS complex performed best and the optimal area for MI detection was the left fourth intercostal area (time integral average 1.8 +/- 1.0 mVms patients, 0.7 +/- 0.5 mVms controls, P = 0.024). For inferior and posterior MI the mid-phases of the QRS complex were the best and the optimal area was the mid-inferior area of the thorax (time integral average -6.2 +/- 8.3 mVms patients, 3.3 +/- 4.3 mVms controls, P = 0.002; -9.1 +/- 6.1 mVms patients, 0.6 +/- 7.1 mVms controls, P = 0.001, respectively).
Time segment analysis of the depolarization wave offers potential for improving the detection and localization of healed MI.
我们研究了通过体表电位标测（BSPM）记录的去极化波的不同时间段检测和定位心肌梗死（MI）的能力。
对24例陈旧性心肌梗死患者和24例健康对照者进行体表电位标测。采用电影和对比增强磁共振成像（MRI）作为参考方法。根据心肌梗死的解剖位置对患者进行分组。将QRS波群分为六个时间相等的段，并计算其时间积分。
根据心肌梗死的位置，QRS波群的时间段显示出不同的心肌梗死检测能力。对于前壁梗死，QRS波群的第二段在心肌梗死检测中表现最佳，最佳区域位于胸部右下象限（时间积分平均值：患者为-1.5±1.8mVms，对照组为1.0±1.6mVms，P = 0.002）。对于侧壁梗死，QRS波群的第一段表现最佳，心肌梗死检测的最佳区域是左第四肋间区域（时间积分平均值：患者为1.8±1.0mVms，对照组为0.7±0.5mVms，P = 0.024）。对于下壁和后壁心肌梗死，QRS波群的中期表现最佳，最佳区域是胸部中下区域（时间积分平均值：患者分别为-6.2±8.3mVms和-9.1±6.1mVms，对照组分别为3.3±4.3mVms和0.6±7.1mVms，P = 0.002和P = 0.001）。
去极化波的时间段分析为改善陈旧性心肌梗死的检测和定位提供了潜力。
