Effect of increased left ventricle mass on ischemia assessment in electrocardiographic signals: rabbit isolated heart study

BMC Cardiovascular Disorders

Research Article

Miroslava Hlavacova¹  Hana Paulova¹  Oto Janousek²  Marina Ronzhina²  Jakub Hejc²  Jana Kolarova²  Tibor Stracina³  Veronika Olejnickova⁴  Marie Novakova⁵ 

[1] Department of Biochemistry, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic;Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Technická 12, 616 00, Brno, Czech Republic;Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic;Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic;Institute of Anatomy, First Faculty of Medicine, Charles University in Prague, U Nemocnice 3, 128 00, Prague, Czech Republic;Institute of Physiology, Czech Academy of Sciences, Vídeňská 1083, 142 20, Praque, Czech Republic;Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic;International Clinical Research Center, St. Anne’s University Hospital Brno, Pekářská 53, 656 91, Brno, Czech Republic;

关键词: Myocardial ischemia detection;    Increased left ventricular mass;    Electrogram;    ROC analysis;    Isolated heart;    Rabbit;   

DOI  :  10.1186/s12872-017-0652-9

 received in 2017-02-16, accepted in 2017-07-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDetailed quantitative analysis of the effect of left ventricle (LV) hypertrophy on myocardial ischemia manifestation in ECG is still missing. The associations between both phenomena can be studied in animal models. In this study, rabbit isolated hearts with spontaneously increased LV mass were used to evaluate the effect of such LV alteration on ischemia detection criteria and performance.MethodsElectrophysiological effects of increased LV mass were evaluated on sixteen New Zealand rabbit isolated hearts under non-ischemic and ischemic conditions by analysis of various electrogram (EG) parameters. To reveal hearts with increased LV mass, LV weight/heart weight ratio was proposed. Standard paired and unpaired statistical tests and receiver operating characteristics analysis were used to compare data derived from different groups of animals, monitor EG parameters during global ischemia and evaluate their ability to discriminate between unchanged and increased LV as well as non-ischemic and ischemic state.ResultsSuccessful evaluation of both increased LV mass and ischemia is lead-dependent. Particularly, maximal deviation of QRS and area under QRS associated with anterolateral heart wall respond significantly to even early phase (the 1st-3rd min) of ischemia. Besides ischemia, these parameters reflect increased LV mass as well (with sensitivity reaching approx. 80%). However, the sensitivity of the parameters to both phenomena may lead to misinterpretations, when inappropriate criteria for ischemia detection are selected. Particularly, use of cut-off-based criteria defined from control group for ischemia detection in hearts with increased LV mass may result in dramatic reduction (approx. 15%) of detection specificity due to increased number of false positives. Nevertheless, criteria adjusted to particular experimental group allow achieving ischemia detection sensitivity of 89–100% and specificity of 94–100%, respectively.ConclusionsIt was shown that response of the heart to myocardial ischemia can be successfully evaluated only when taking into account heart-related factors (such as LV mass) and other methodological aspects (such as recording electrodes position, selected EG parameters, cut-off criteria, etc.). Results of this study might be helpful for developing new clinical diagnostic strategies in order to improve myocardial ischemia detection in patients with LV hypertrophy.

【 授权许可】

CC BY   
© The Author(s). 2017