Li Ronghua, Zhao Xiaoye, Gong Yinglan, Zhang Jucheng, Dong Ruiqing, Xia Ling
Key Laboratory for Biomedical Engineering of Ministry of Education, Institute of Biomedical Engineering, Zhejiang University, Hangzhou, China.
Department of Medical Imaging Technology, North Minzu University, Yinchuan, China.
Front Physiol. 2021 Mar 31;12:660232. doi: 10.3389/fphys.2021.660232. eCollection 2021.
In recent years, coronary heart disease (CHD) has become one of the main diseases that endanger human health, with a high mortality and disability rate. Myocardial ischemia (MI) is the main symptom in the development of CHD. Continuous and severe myocardial ischemia will lead to myocardial infarction. The clinical manifestations of MI are mainly the changes of ST-T segment of ECG, that is, ST segment and T wave. Nearly one third of patients with CHD, however, has no obvious ECG changes. In this paper, a new method for detecting MI based on the T-wave area curve (TWAC) was proposed. Through observation and analysis of clinical data, it was found that there exist significant correlation between the morphology of TWAC and MI. The TWAC morphology of normal subject is smooth and gentle, while the TWAC morphology of patients with coronary stenosis is mostly jagged, and the curve becomes more severe with more severe stenosis. The preliminary test results show that the sensitivity, specificity, and accuracy of the proposed method for detecting MI are 84.3, 83.6, and 84%, respectively. This study shows that the TWAC based approach may be an effective method for detecting MI, especially for the CHD patients with no obvious ECG changes.
近年来，冠心病（CHD）已成为危害人类健康的主要疾病之一，死亡率和致残率很高。心肌缺血（MI）是冠心病发展过程中的主要症状。持续严重的心肌缺血会导致心肌梗死。心肌梗死的临床表现主要是心电图ST-T段的变化，即ST段和T波。然而，近三分之一的冠心病患者没有明显的心电图变化。本文提出了一种基于T波面积曲线（TWAC）检测心肌梗死的新方法。通过对临床数据的观察和分析，发现TWAC形态与心肌梗死之间存在显著相关性。正常受试者的TWAC形态平滑柔和，而冠状动脉狭窄患者的TWAC形态大多呈锯齿状，且狭窄越严重曲线越明显。初步测试结果表明，所提心肌梗死检测方法的灵敏度、特异度和准确度分别为84.3%、83.6%和84%。本研究表明，基于TWAC的方法可能是检测心肌梗死的有效方法，尤其是对于无明显心电图变化的冠心病患者。
