Hänninen Helena, Holmström Miia, Vesterinen Paula, Karvonen Milla, Väänänen Heikki, Oikarinen Lasse, Mäkijärvi Markku, Nenonen Jukka, Lauerma Kirsi, Katila Toivo, Toivonen Lauri
Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland.
Ann Noninvasive Electrocardiol. 2006 Jul;11(3):211-21. doi: 10.1111/j.1542-474X.2006.00106.x.
We evaluated the capability of multichannel magnetocardiography (MCG) to detect healed myocardial infarction (MI).
Multichannel MCG over frontal chest was recorded at rest in 21 patients with healed MI, detected by cine- and contrast-enhanced magnetic resonance imaging, and in 26 healthy controls. Of the 21 MI patients, 11 had non-Q wave and 10 Q wave MIs. QRS, ST-segment, T wave and ST-T wave integrals, ST-segment and T wave amplitudes, and QRS and ST-T wave magnetic field map orientations were measured.
The MCG repolarization indexes, such as ST segment and ST-T wave integrals, separated the MI group from the controls (ST-T wave integral -1.4 +/- 5.3 vs 1.5 +/- 4.7 pTs, P = 0.034). The abnormalities were more distinct in the Q wave-MI than in the non-Q wave MI subgroup. In the latter, however, a trend similar to the Q wave MI group was found. The relation of QRS area to ST segment and T wave integral improved the detection of healed MIs compared to the ST-T wave indexes alone (QRS-ST-T discordance 14 +/- 10 vs 5.0 +/- 7.1 pTs, P = 0.003). When comparing the MI group to the controls, the orientation of the magnetic field maps differed in the ST-T wave maps (163 +/- 119 degrees vs 58 +/- 17 degrees, P < 0.001) but not in the QRS maps (111 +/- 95 degrees vs 106 +/-93 degrees, P = 0.646).
The MCG repolarization variables can detect healed MI. These ST-T wave abnormalities are more pronounced in patients with Q wave MI than in patients with non-Q wave MIs. Relating the signals of depolarization and repolarization phases improves the detection of healed MI. Repolarization abnormalities are common in healed MI and thus should not always be interpreted as present ongoing ischemia.
我们评估了多通道心磁图（MCG）检测陈旧性心肌梗死（MI）的能力。
对21例经电影和对比增强磁共振成像检测为陈旧性MI的患者及26例健康对照者在静息状态下进行胸前区多通道MCG记录。21例MI患者中，11例为非Q波MI，10例为Q波MI。测量了QRS波、ST段、T波和ST - T波积分、ST段和T波振幅以及QRS波和ST - T波磁场图方向。
MCG复极指标，如ST段和ST - T波积分，可将MI组与对照组区分开来（ST - T波积分 -1.4±5.3对1.5±4.7 pTs，P = 0.034）。Q波MI组的异常比非Q波MI亚组更明显。然而，在后者中也发现了与Q波MI组相似的趋势。与单独的ST - T波指标相比，QRS面积与ST段和T波积分的关系改善了陈旧性MI的检测（QRS - ST - T不一致性14±10对5.0±7.1 pTs，P = 0.003）。将MI组与对照组比较时，磁场图方向在ST - T波图中不同（163±119度对58±17度，P < 0.001），但在QRS图中无差异（111±95度对106±93度，P = 0.646）。
MCG复极变量可检测陈旧性MI。这些ST - T波异常在Q波MI患者中比在非Q波MI患者中更明显。将去极化和复极化阶段的信号关联起来可改善陈旧性MI的检测。复极异常在陈旧性MI中很常见，因此不应总是将其解释为存在进行性缺血。
