Document Detail


Simple, quantitative body surface potential map parameters in the diagnosis of remote Q wave and non-Q wave myocardial infarction.
MedLine Citation:
PMID:  15457307     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Body surface potential mapping has been shown to be a useful tool in the diagnosis and localization of remote non-Q wave and Q wave myocardial infarction, but human expertise is required to interpret the maps. OBJECTIVE: To identify quantitative body surface potential mapping parameters that could enable a computer-based diagnosis. METHODS: Body surface isopotential maps (63 unipolar leads) were recorded in 86 patients with remote Q wave and 71 patients with remote non-Q wave myocardial infarction. Twenty-four healthy adults served as control subjects. Myocardial infarctions were classified using standard electrocardiogram leads in the acute and chronic phases, and were validated by coronary angiography, ventriculography and thallium scintigraphy. RESULTS: Two simple quantitative parameters with high diagnostic power were identified: the time interval between the peak minimum and the peak maximum potentials (time-shift), and the ratio of these potentials (maximum to minimum ratio [max/min]). Both parameters showed significant differences between infarction patients and normal control subjects, and optimum cut-off values were determined using receiver operating characteristic curves (anterior infarction: time-shift of -4 ms or less, max/min of 0.6 or less; posterior infarction: time-shift of 8 ms or greater, max/min of 1.25 or greater). The sensitivities of the two parameters were 100% and 97%, and the specificities were 99% and 100%, respectively, in the anterior Q wave infarction group, compared with sensitivities of 88% and 100%, and specificities of 94% and 95%, respectively, in the posterior Q wave infarction group. In the anterior non-Q wave infarction group, sensitivity was 35% for both parameters, specificity was 100% for both parameters, and only infarctions associated with a low ejection fraction were detected, indicating that infarction size may influence the power of the tests. CONCLUSIONS: Time-shift and max/min are two new, simple, powerful parameters for infarction diagnosis and may also be suitable for automated, computer-based processing.
Authors:
Mihály Medvegy; Pierre Savard; Arnold Pintér; Gaétan Tremblay; James B Nasmith; Donald Palisaitis; Gábor Duray; István Préda; Réginald A Nadeau
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  20     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-30     Completed Date:  2004-11-08     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1109-15     Citation Subset:  IM    
Affiliation:
Research Centre, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Quebec.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Body Surface Potential Mapping*
Case-Control Studies
Electrocardiography / methods*
Female
Follow-Up Studies
Heart Function Tests
Humans
Hypertrophy, Left Ventricular / diagnosis*
Male
Middle Aged
Myocardial Infarction / diagnosis*
Predictive Value of Tests
Reference Values
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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