Comparison of Electric- and Magnetic-Cardiograms Produced by Myocardial Ischemia in Models of the Human Ventricle and Torso.
Comparison of Electric- and Magnetic-Cardiograms Produced by Myocardial Ischemia in Models of the Human Ventricle and Torso.
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DOI：
10.1371/journal.pone.0160999
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Zhang H
中科院分区：
文献类型：
--
作者：
Alday EA;Ni H;Zhang C;Colman MA;Gan Z;Zhang H
心肌心室缺血是由于心脏供血不足而引起的，这可能导致组织中异常的复极和兴奋波传导模式，导致心律失常甚至猝死。目前通过12导联心电图（ECG）诊断心肌缺血具有局限性，因为它们在许多情况下不敏感，并且可能显示与正常模式的不明显差异。由于磁场提供关于心脏兴奋的额外信息，并且对胸部表面的切向电流更敏感，而电场对通量电流更敏感，因此假设心磁图（MCG）可以在缺血性诊断中提供ECG的补充方法。然而，目前尚不清楚体表ECG和MCG信号对缺血条件的敏感区域的差异。本研究的目的是研究这种差异，使用12-，36- ECG和36-MCG计算从多尺度生物病理学详细的计算模型的人心室和躯干在控制和缺血条件。结果表明，缺血引起ECG和MCG信号在QRS波群、T波和ST段的变化，与12导联ECG相比，36导联ECG和MCG的相对差异更大（分别为34%和37%对26%）。36导联心电图对缺血引起的T波改变的平均敏感性高于MCG（分别为37%和32%），而MCG对ST段改变的敏感性高于ECG（分别为50%和40%）。此外，MCG和ECG均显示缺血的区域依赖性变化，但MCG显示心脏缺血区域之间的相关性更强。结论：MCG对心肌缺血的敏感性高于ECG，为心肌缺血的诊断提供了一种新的方法。
Myocardial ventricular ischemia arises from a lack of blood supply to the heart, which may cause abnormal repolarization and excitation wave conduction patterns in the tissue, leading to cardiac arrhythmias and even sudden death. Current diagnosis of cardiac ischemia by the 12-lead electrocardiogram (ECG) has limitations as they are insensitive in many cases and may show unnoticeable differences to normal patterns. As the magnetic field provides extra information on cardiac excitation and is more sensitive to tangential currents to the surface of the chest, whereas the electric field is more sensitive to flux currents, it has been hypothesized that the magnetocardiogram (MCG) may provide a complementary method to the ECG in ischemic diagnosis. However, it is unclear yet about the differences in sensitivity regions of body surface ECG and MCG signals to ischemic conditions. The aim of this study was to investigate such differences by using 12-, 36- ECG and 36-MCG computed from multi-scale biophysically detailed computational models of the human ventricles and torso in both control and ischemic conditions. It was shown that ischemia produced changes in the ECG and MCG signals in the QRS complex, T-wave and ST-segment, with greater relative differences seen in the 36-lead ECG and MCG as compared to the 12-leads ECG (34% and 37% vs 26%, respectively). The 36-lead ECG showed more averaged sensitivity than the MCG in the change of T-wave due to ischemia (37% vs 32%, respectively), whereas the MCG showed greater sensitivity than the ECG in the change of the ST-segment (50% vs 40%, respectively). In addition, both MCG and ECG showed regional-dependent changes to ischemia, but with MCG showing a stronger correlation between ischemic region in the heart. In conclusion, MCG shows more sensitivity than ECG in response to ischemia, which may provide an alternative method for the diagnosis of ischemia.