Article
Derived epicardial potentials differentiate ischemic ST depression from ST depression secondary to ST elevation in acute inferior myocardial infarction in humans.
Department of Medicine, University of Tasmania, Australia.
Journal of the American College of Cardiology (Impact Factor: 14.09). 10/1989; 14(3):695702; discussion 7034. DOI: 10.1016/07351097(89)901125 Source: PubMed

Article: Computing the size and location of myocardial ischemia using measurements of STsegment shift.
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ABSTRACT: It is well known that the presence of myocardial ischemia can be observed as a shift in the ST segment of an electrocardiogram (ECG) recording. The question we address in this paper is whether or not ST shift can be used to compute approximations of the size and location of the ischemic region. We begin by investigating a cost functional (measuring the difference between synthetic recorded data and simulated values of ST shift) for a parameter identification problem to locate the ischemic region. We then formulate a more flexible representation of the ischemia using a level set framework and solve the associated minimization problem for the size and position of the ischemia. We apply this framework to a set of ECG data generated by the Bidomain model using the cell model of Winslow et al. Based on this data, we show that values of ST shift recorded at the body surface are capable of identifying the position and (roughly) the size of the ischemia.IEEE Transactions on Biomedical Engineering 07/2006; 53(6):102431. · 2.35 Impact Factor  [Show abstract] [Hide abstract]
ABSTRACT: The presence of electrocardiographic ST depression in acute infarction remains controversial and poorly explained. A combined animal and modeling study was performed to evaluate the source of ST changes in acute infarction. In anaesthetized sheep, small infarcts showed uniform ST elevation over the infarction whereas larger infarcts showed marked ST depression over the normal myocardium in addition to the ST elevation. These findings were replicated by bidomain models of the heart. A hollow sphere was used to model a gradually increasing infarct, and this showed that there was a decrease in the ratio of ST elevation to ST depression as the infarct was increased. The current flowing out of the heart must be identical to the current flowing back into the heart. This means that any infarction will produce ST depression as well as ST elevation, the ratio between the two being related to the size of the infarction. Small infarction is associated with a small region of ST elevation and minor ST depression of the remaining myocardium, and as the infarct region increases, the amplitude of the epicardial ST elevation falls and the amplitude of the ST depression increases. Infarction size is proportional to both the height of the ST depression on the epicardium and the strength of the epicardial ST segment dipole.Circulation Research 12/1999; 85(10):95964. · 11.86 Impact Factor  [Show abstract] [Hide abstract]
ABSTRACT: There is a complex interplay between the four conductivity values used in the bidomain equation and the resulting electric potential distribution in cardiac tissue arising from subendocardial ischaemia. Based on the three commonly used experimentally derived conductivity data sets, a nondimensional formulation of the passive bidomain equation is derived, which gives rise naturally to several dimensionless conductivity ratios. The data sets are then used to define a parameter space of these ratios, which is studied by considering the correlation coefficients between different epicardial potential distributions. From this study, it is shown that the ratio of the intracellular longitudinal conductivity to the intracellular transverse conductivity is the key parameter in explaining the differences between the epicardial potential distributions observed with these three data sets.Mathematical biosciences 05/2011; 232(2):14250. · 1.30 Impact Factor
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