Scientific Computing and Imaging Institute, SLC, UT, United States of America. Nora Eccles Cardiovascular Research and Training Institute, SLC, UT, United States of America. School of Medicine, University of Utah, SLC, UT, United States of America. Department of Biomedical Engineering, University of Utah, SLC, UT, United States of America. Author to whom any correspondence should be addressed.
Physiol Meas. 2020 Feb 5;41(1):015002. doi: 10.1088/1361-6579/ab64b9.
Myocardial ischemia is one of the most common cardiovascular pathologies and can indicate many severe and life threatening diseases. Despite these risks, current electrocardiographic detection techniques for ischemia are mediocre at best, with reported sensitivity and specificity ranging from 50%-70% and 70%-90%, respectively.
To improve this performance, we set out to develop an experimental preparation to induce, detect, and analyze bioelectric sources of myocardial ischemia and determine how these sources reflect changes in body-surface potential measurements.
We designed the experimental preparation with three important characteristics: (1) enable comprehensive and simultaneous high-resolution electrical recordings within the myocardial wall, on the heart surface, and on the torso surface; (2) develop techniques to visualize these recorded electrical signals in time and space; and (3) accurately and controllably simulate ischemic stress within the heart by modulating the supply of blood, the demand for perfusion, or a combination of both.
To achieve these goals we designed comprehensive system that includes (1) custom electrode arrays (2) signal acquisition and multiplexing units, (3) a surgical technique to place electrical recording and myocardial ischemic control equipment, and (4) an image based modeling pipeline to acquire, process, and visualize the results. With this setup, we are uniquely able to capture simultaneously and continuously the electrical signatures of acute myocardial ischemia within the heart, on the heart surface, and on the body surface.
This novel experimental preparation enables investigation of the complex and dynamic nature of acute myocardial ischemia that should lead to new, clinically translatable results.
心肌缺血是最常见的心血管病理之一，可表明许多严重的危及生命的疾病。尽管存在这些风险，但目前用于检测缺血的心电图技术最多只能说是中等水平，其报告的灵敏度和特异性分别在 50%-70%和 70%-90%之间。
为了提高这一性能，我们着手开发一种实验准备，以诱导、检测和分析心肌缺血的生物电源，并确定这些源如何反映体表电位测量的变化。
我们设计了实验准备，具有三个重要特征：（1）能够在心肌壁内、心脏表面和躯干表面进行全面和同时的高分辨率电记录；（2）开发技术以在时间和空间上可视化这些记录的电信号；（3）通过调节血液供应、灌注需求或两者的组合，准确和可控地模拟心脏内的缺血应激。
为了实现这些目标，我们设计了一个综合系统，包括（1）定制的电极阵列，（2）信号采集和多路复用单元，（3）一种放置电记录和心肌缺血控制设备的手术技术，以及（4）一个基于图像的建模管道，用于获取、处理和可视化结果。有了这个设置，我们能够独特地同时连续捕获心脏内、心脏表面和体表的急性心肌缺血的电信号特征。
这种新的实验准备使我们能够研究急性心肌缺血的复杂和动态性质，这应该会带来新的、可临床转化的结果。
