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磁心动图与32导联电位标测:正常受试者在药物诱导应激期间的复极化

Magnetocardiography and 32-lead potential mapping: repolarization in normal subjects during pharmacologically induced stress.

作者信息

Brockmeier K, Schmitz L, Bobadilla Chavez J D, Burghoff M, Koch H, Zimmermann R, Trahms L

机构信息

Department of Pediatric Cardiology, Virchow Medical Center, Humboldt Universität Berlin, Germany.

出版信息

J Cardiovasc Electrophysiol. 1997 Jun;8(6):615-26. doi: 10.1111/j.1540-8167.1997.tb01824.x.

Abstract

Signals from 37 magnetocardiographic sensors and simultaneously recorded 32 ECG leads were obtained in three healthy male subjects (including two reinvestigations). After recordings at rest, the heart rate was increased by pharmacologic stress (117 to 142 beats/min). Comparison of the repolarization of rest and stress showed substantial changes in the magnetocardiogram (MCG) up to T wave inversions during stress. In the ECG only junctional ST-T segment shifts were present. For quantification, correlation coefficients between pairs of rest and stress MCG and rest and stress ECG distributions were calculated for the same time instant at the beginning of T wave under rest and stress conditions. In addition, equivalent electrical current dipole moment and magnetic dipole moment vectors were calculated from the MCG, and their change from rest to stress evaluated. Correlation coefficients for MCG comparison ranged from 0.3 to 0.5; ECG comparison suggested much less change from stress, ranging from 0.7 to 1.0. Current dipole moment changes at T wave onset were marginal; in contrast, the magnetic dipole moment changed substantially. Since the magnetic dipole reflects vortex currents, changes in its intensity and/or orientation during repolarization suggest this as the biophysical basis of the striking difference in the response of the MCG and ECG to pharmacologic stress. Normal ECG findings at rest and under stress in healthy subjects support the conclusion that the repolarization changes in the MCG were of nonpathologic origin.

摘要

在三名健康男性受试者(包括两次复查)中获取了来自37个心磁图传感器的信号以及同时记录的32导联心电图。在静息记录后,通过药物应激使心率增加(117至142次/分钟)。静息和应激时复极化的比较显示,应激期间心磁图(MCG)出现了显著变化,直至T波倒置。而心电图仅出现交界性ST-T段移位。为了进行量化,计算了静息和应激时同一时刻T波起始点的静息与应激MCG对以及静息与应激心电图分布之间的相关系数。此外,从MCG计算出等效电流偶极矩和磁偶极矩矢量,并评估它们从静息到应激的变化。MCG比较的相关系数范围为0.3至0.5;心电图比较表明应激时变化小得多,范围为0.7至1.0。T波起始时电流偶极矩变化很小;相比之下,磁偶极矩变化很大。由于磁偶极反映涡电流,其在复极化过程中强度和/或方向的变化表明这是MCG和心电图对药物应激反应存在显著差异的生物物理基础。健康受试者静息和应激时正常的心电图结果支持MCG复极化变化为非病理性起源的结论。

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