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The Dipolar ElectroCARdioTOpographic (DECARTO)-like method for graphic presentation of location and extent of area at risk estimated from ST-segment deviations in patients with acute myocardial infarction

Bacharova, Ljuba; Mateasik, Anton; Carnicky, Jan; Ubachs, Joey LU ; Hedström, Erik LU ; Arheden, Håkan LU and Engblom, Henrik LU (2009) In Journal of Electrocardiology 42(2). p.172-180
Abstract
A graphic method was developed for presentation of the location and extent of the myocardium at risk in patients with acute myocardial infarction (AMI). This method is based on a mathematical processing of ST-segment deviations of standard 12-lead electrocardiogram following the concept of Titomir and Ruttkay-Nedecky in their dipolar electrocardiotopographic method. The center of the location of the area at risk is given by the spatial orientation of the resultant spatial ST vector, and the extent of the area at risk is derived from the Aldrich score. The areas at risk are projected on a spherical image surface, on which a texture of the anatomical quadrants of the ventricular surface and its coronary artery supply are projected. The... (More)
A graphic method was developed for presentation of the location and extent of the myocardium at risk in patients with acute myocardial infarction (AMI). This method is based on a mathematical processing of ST-segment deviations of standard 12-lead electrocardiogram following the concept of Titomir and Ruttkay-Nedecky in their dipolar electrocardiotopographic method. The center of the location of the area at risk is given by the spatial orientation of the resultant spatial ST vector, and the extent of the area at risk is derived from the Aldrich score. The areas at risk are projected on a spherical image surface, on which a texture of the anatomical quadrants of the ventricular surface and its coronary artery supply are projected. The method was tested in 10 patients with AMI with single-vessel disease, including 6 patients with an occlusion in the proximal left anterior descending coronary artery (LAD), 3 patients with an occlusion in the right coronary artery, and one patient with occlusion in the left circumflex coronary artery. The estimated areas at risk were compared with myocardial perfusion single photon emission computed tomography. Eight (80%) patients of 10 were correctly localized according to the Aldrich decision rules for the location of AMI. The areas at risk in patients with LAD occlusion correctly localized by the Aldrich score were situated in the anteroseptal and anterosuperior quadrants. In the inferior AMI group, the area at risk was localized in the posterolateral and inferior quadrants. The visual comparison with myocardial perfusion single photon emission computed tomography (SPECT) showed best agreement in patients with LAD involvement. The initial testing showed that this method allows a graphic presentation of estimated area at risk using clinically defined diagnostic rules. The area at risk can be displayed in images that are familiar for clinicians and can be compared with or superimposed on results of other imaging methods used in cardiology. (C) 2009 Elsevier Inc. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
SPECT, Area at risk, ST deviation, ECG, Myocardial infarction
in
Journal of Electrocardiology
volume
42
issue
2
pages
172 - 180
publisher
Elsevier
external identifiers
  • wos:000264220000011
  • scopus:60349086971
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2008.12.005
language
English
LU publication?
yes
id
27c7761d-2e33-4543-a250-9fdfaa464276 (old id 1404789)
date added to LUP
2009-06-15 09:46:25
date last changed
2017-01-01 05:06:52
@article{27c7761d-2e33-4543-a250-9fdfaa464276,
  abstract     = {A graphic method was developed for presentation of the location and extent of the myocardium at risk in patients with acute myocardial infarction (AMI). This method is based on a mathematical processing of ST-segment deviations of standard 12-lead electrocardiogram following the concept of Titomir and Ruttkay-Nedecky in their dipolar electrocardiotopographic method. The center of the location of the area at risk is given by the spatial orientation of the resultant spatial ST vector, and the extent of the area at risk is derived from the Aldrich score. The areas at risk are projected on a spherical image surface, on which a texture of the anatomical quadrants of the ventricular surface and its coronary artery supply are projected. The method was tested in 10 patients with AMI with single-vessel disease, including 6 patients with an occlusion in the proximal left anterior descending coronary artery (LAD), 3 patients with an occlusion in the right coronary artery, and one patient with occlusion in the left circumflex coronary artery. The estimated areas at risk were compared with myocardial perfusion single photon emission computed tomography. Eight (80%) patients of 10 were correctly localized according to the Aldrich decision rules for the location of AMI. The areas at risk in patients with LAD occlusion correctly localized by the Aldrich score were situated in the anteroseptal and anterosuperior quadrants. In the inferior AMI group, the area at risk was localized in the posterolateral and inferior quadrants. The visual comparison with myocardial perfusion single photon emission computed tomography (SPECT) showed best agreement in patients with LAD involvement. The initial testing showed that this method allows a graphic presentation of estimated area at risk using clinically defined diagnostic rules. The area at risk can be displayed in images that are familiar for clinicians and can be compared with or superimposed on results of other imaging methods used in cardiology. (C) 2009 Elsevier Inc. All rights reserved.},
  author       = {Bacharova, Ljuba and Mateasik, Anton and Carnicky, Jan and Ubachs, Joey and Hedström, Erik and Arheden, Håkan and Engblom, Henrik},
  issn         = {1532-8430},
  keyword      = {SPECT,Area at risk,ST deviation,ECG,Myocardial infarction},
  language     = {eng},
  number       = {2},
  pages        = {172--180},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {The Dipolar ElectroCARdioTOpographic (DECARTO)-like method for graphic presentation of location and extent of area at risk estimated from ST-segment deviations in patients with acute myocardial infarction},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2008.12.005},
  volume       = {42},
  year         = {2009},
}