Cardiovascular Research Centre, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
J Cardiovasc Transl Res. 2009 Mar;2(1):48-62. doi: 10.1007/s12265-008-9080-7. Epub 2008 Dec 10.
Combined analysis of the electrical and mechanical function of the heart holds promise as a means of acquiring a better understanding of a variety of cardiac diseases that ultimately may lead to heart failure. The NOGA XP Cardiac Navigation System is a unique, nonfluoroscopic, catheter-based technology that achieves real-time acquisition of three-dimensional, endoventricular electromechanical maps. Through the provision of point-by-point measurements of endocardial electrical activation and voltage and mechanical shortening, electromechanical mapping has been evaluated for its ability to identify regional myocardial ischemia and characterize tissue viability. A decade of preclinical and clinical research has verified its safety and feasibility and raised the possibility of its application as a diagnostic adjunct to conventional angiography in the catheterization laboratory. However, this role has not yet been realized outside of the research setting. Instead, a more prominent niche for NOGA XP has emerged as a therapeutic tool for guiding direct myocardial interventions, most notably the targeted administration of regenerative therapies (e.g., cells, genes) to the heart. In this review, we discuss the fundamental aspects of this electromechanical mapping system and the evidence for both its diagnostic and therapeutic utility.
联合分析心脏的电和机械功能有望成为一种手段，更好地了解各种最终可能导致心力衰竭的心脏疾病。NOGA XP 心脏导航系统是一种独特的、无荧光透视的、基于导管的技术，可实时获取三维心室内电机械图。通过提供心内膜电激活和电压以及机械缩短的逐点测量，电机械图已被评估其识别局部心肌缺血和表征组织活力的能力。十年来的临床前和临床研究已经验证了其安全性和可行性，并提出了将其作为导管实验室中常规血管造影的辅助诊断手段的可能性。然而，这种作用尚未在研究环境之外得到实现。相反，NOGA XP 作为一种治疗工具，用于指导直接心肌介入的作用更加突出，尤其是将再生疗法（例如细胞、基因）靶向递送至心脏。在这篇综述中，我们讨论了这种电机械映射系统的基本方面及其诊断和治疗效用的证据。
