一个简单的数字体表映射参数表明经皮冠状动脉介入治疗成功。

A Simple Numerical Body Surface Mapping Parameter Signifies Successful Percutaneous Coronary Artery Intervention.

作者信息

Simonyi Gábor, Kirschner Róbert, Szűcs Endre, Préda István, Duray Gábor, Medvegy Nóra, Horvath Bálint, Medvegy Mihály

机构信息

Metabolic Center, Szent Imre University Teaching Hospital, Budapest, Hungary.

Flor Ferenc Hospital of Pest County, Kistarcsa, Hungary.

出版信息

Ann Noninvasive Electrocardiol. 2016 Mar;21(2):161-8. doi: 10.1111/anec.12281. Epub 2015 Jun 24.

DOI:10.1111/anec.12281

PMID:26105057

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6931438/

Abstract

BACKGROUND

In coronary artery disease (CAD), body surface potential mapping (BSPM) may reveal minor electrical potential changes appearing in the depolarization phase even if pathological changes are absent on the conventional 12-lead ECG. We hypothesized that a simple BSPM parameter, Max/Min signifies successful percutaneous coronary intervention (PCI).

METHODS

Ninety-two adult Caucasian patients with stable CAD and positive exercise test underwent coronary angiography. Seventy patients (age, 59 ± 8; 46 males) were revascularized by PCI (left anterior descending [LAD] in 38, right [RCA] in 17 and left circumflex [LCX] coronary artery in 15). Control groups contained 22 patients (age, 60 ± 8; 14 males) without intervention and 35 healthy subjects (age, 58 ± 2; 15 males). Left ventricular ejection fraction (LVEF, transthoracic echocardiography) and Max/Min BSPM parameter (63-lead Montreal system) were evaluated before and 4-40 days following coronary angiography. Max/Min was defined by the ratio of the highest maximum to the deepest minimum potential of all leads recorded by BSPM.

RESULTS

Before PCI, Max/Min value of patients with LAD lesion (0.83 [0.74; 0.93]) was significantly lower while that with RCA lesion (1.63 [1.35; 1.99]) was significantly higher than that of healthy group (1.01 [0.970; 1.13]) (P < 0.05) and LVEF was significantly lower in LAD lesion (46.50% [43.00; 51.00]) than in the healthy group (55.00% [50.00; 58.75]) (P < 0.01). Max/Min value significantly increased from 0.83 [0.74; 0.93] to 0.92 [0.82; 0.99] (P < 0.01) following LAD PCI while significantly decreased from 1.63 [1.35; 1.98] to 1.35 [1.21; 1.43] (P < 0.01) post-RCA PCI. It did not vary significantly, however, either following LCX PCI or without intervention. LVEF significantly increased (from 46.50% [43.00; 51.00] to 49.00% [46.00; 51.00]) only after LAD PCI.

CONCLUSION

Max/Min parameter is suitable to follow patients after LAD and RCA PCI.

摘要

背景

在冠状动脉疾病（CAD）中，体表电位标测（BSPM）可能会揭示在去极化阶段出现的微小电位变化，即使传统12导联心电图上没有病理变化。我们假设一个简单的BSPM参数，即最大/最小值（Max/Min）意味着经皮冠状动脉介入治疗（PCI）成功。

方法

92例患有稳定型CAD且运动试验阳性的成年白种人患者接受了冠状动脉造影。70例患者（年龄59±8岁；46例男性）接受了PCI血运重建（左前降支[LAD]病变38例，右冠状动脉[RCA]病变17例，左旋支[LCX]病变15例）。对照组包括22例未接受干预的患者（年龄60±8岁；14例男性）和35例健康受试者（年龄58±2岁；15例男性）。在冠状动脉造影前以及造影后4 - 40天评估左心室射血分数（LVEF，经胸超声心动图）和Max/Min BSPM参数（63导联蒙特利尔系统）。Max/Min定义为BSPM记录的所有导联中最高最大值与最深最小值的比值。

结果

PCI前，LAD病变患者的Max/Min值（0.83[0.74；0.93]）显著低于RCA病变患者（1.63[1.35；1.99]），且均低于健康组（1.01[0.970；1.13]）（P<0.05）；LAD病变患者的LVEF（46.50%[43.00；51.00]）显著低于健康组（55.00%[50.00；58.75]）（P<0.01）。LAD PCI后，Max/Min值从0.83[0.74；0.93]显著增加至0.92[0.82；0.99]（P<0.01），而RCA PCI后从1.63[1.35；1.98]显著降低至1.35[1.21；1.43]（P<0.01）。然而，LCX PCI后或未干预组中，该值无显著变化。仅LAD PCI后LVEF显著增加（从46.50%[43.00；51.00]增至49.00%[46.00；51.00]）。