Ryu Ah-Jin, Lee Kyung Eun, Kwon Soon-Sung, Shin Eun-Seok, Shim Eun Bo
SiliconSapiens Co, Seoul 06153, Korea.
Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon 24341, Korea.
Korean J Physiol Pharmacol. 2019 Jan;23(1):71-79. doi: 10.4196/kjpp.2019.23.1.71. Epub 2018 Dec 26.
Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.
体表电位图是人体躯干表面的电势分布,它使我们能够推断心脏的电活动。因此,观察投射到躯干表面的电势对于诊断诸如冠状动脉闭塞等心脏病可能非常有用。患者心脏的体表电位图显示出比12导联心电图更高的灵敏度。相关研究大多基于从患者获得的临床统计数据,因此,需要对心脏的各种病理现象进行模拟。在本研究中,通过计算机模拟,根据左前降支冠状动脉的不同闭塞位置(远端、中段、近端闭塞)实现了体表电位图。基于ST等积分图观察和分析了ST段期间体表的电生理特征。我们开发了一个考虑细胞到器官水平的综合系统,并对冠状动脉闭塞开始后前5分钟(阶段1)和10分钟(阶段2)期间发生的心脏电生理现象进行了模拟。随后,我们计算了ST等积分图的双极角度和幅度,并观察了相关特征与冠状动脉闭塞位置之间的相关性。结果,在阶段1的心室模型中,更广泛的缺血区域导致双极角度逆时针旋转;在阶段2,当缺血区域超过一定大小时,幅度增加。