Bacharova Ljuba, Bang Lia E, Szathmary Vavrinec, Mateasik Anton
International Laser Center, 841 04 Bratislava, Slovak Republic; Institute of Pathological Physiology, Medical Faculty, Comenius University, Bratislava, Slovak Republic.
Copenhagen University Hospital, Rigshospitalet, The Heart Center, Department of Cardiology, Denmark.
J Electrocardiol. 2014 Jul-Aug;47(4):438-47. doi: 10.1016/j.jelectrocard.2014.02.004. Epub 2014 Feb 12.
Acute myocardial infarction creates regions of altered electrical properties of myocardium resulting in typical QRS patterns (pathological Q waves) and ST segment deviations observed in leads related to the MI location. The aim of this study was to present a graphical method for imaging the changes in the sequence of depolarization and the ST segment deviations in myocardial infarction using the Dipolar ElectroCARdioTOpography (DECARTO) method.
Simulated ECG data corresponding to intramural, electrically inactive areas encircled by transmural areas with slowed impulse propagation velocity in anteroseptal and inferior locations were used for imaging the altered sequence of depolarization and the ST vector. The ECGs were transformed to areas projected on the image surface so as to image the process of ventricular depolarization based on the orientation and magnitude of the instantaneous QRS vectors, and the estimated "myocardium at risk" based on the ST segment deviation.
The images are presented as Mercator projections with the texture of anatomical segments of the heart and the corresponding coronary artery distribution. The changes in depolarization sequence were visible as dislocations of activated areas circumventing the affected areas, while the "myocardium at risk" estimated from the ST segment deviation pointed to the affected area.
The presented method of imaging ECG allows visualizing changes in sequence of depolarization as well as the ST segment deviations in myocardial infarction and they can be visually compared with non-ECG imaging methods.
急性心肌梗死会导致心肌电特性发生改变的区域，从而在与心肌梗死部位相关的导联中出现典型的QRS波型（病理性Q波）和ST段偏移。本研究的目的是介绍一种使用偶极心电图断层扫描（DECARTO）方法对心肌梗死中去极化顺序变化和ST段偏移进行成像的图形化方法。
使用模拟心电图数据，这些数据对应于前间隔和下壁部位透壁区域环绕的壁内电静止区域，该透壁区域冲动传播速度减慢，用于对去极化顺序改变和ST向量进行成像。将心电图转换为投影在图像表面的区域，以便根据瞬时QRS向量的方向和大小对心室去极化过程进行成像，并根据ST段偏移估计“危险心肌”。
图像以墨卡托投影呈现，带有心脏解剖节段的纹理和相应的冠状动脉分布。去极化顺序的变化表现为激活区域围绕受影响区域的移位，而根据ST段偏移估计的“危险心肌”指向受影响区域。
所介绍的心电图成像方法能够可视化心肌梗死中去极化顺序的变化以及ST段偏移，并且可以与非心电图成像方法进行视觉比较。
