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Titolo:
Electromechanical mapping for detection of myocardial viability in patients with ischemic cardiomyopathy
Autore:
Botker, HE; Lassen, JF; Hermansen, F; Wiggers, H; Sogaard, P; Kim, WY; Bottcher, M; Thuesen, L; Pedersen, AK;
Indirizzi:
Aarhus Univ Hosp, Skejby Hosp, Dept Cardiol, DK-8200 Aarhus N, Denmark Aarhus Univ Hosp Aarhus Denmark N ept Cardiol, DK-8200 Aarhus N, Denmark Aarhus Univ Hosp, Aarhus Kommune Hosp, PET Ctr, DK-8200 Aarhus, Denmark Aarhus Univ Hosp Aarhus Denmark DK-8200 PET Ctr, DK-8200 Aarhus, Denmark
Titolo Testata:
CIRCULATION
fascicolo: 12, volume: 103, anno: 2001,
pagine: 1631 - 1637
SICI:
0009-7322(20010327)103:12<1631:EMFDOM>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
ECHOCARDIOGRAPHY; HEART;
Keywords:
electrocardiography; electrophysiology; endocardium; hibernation; infarction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
18
Recensione:
Indirizzi per estratti:
Indirizzo: Botker, HE Aarhus Univ Hosp, Skejby Hosp, Dept Cardiol, Brendstrupgaardsvej, DK-8200 Aarhus N, Denmark Aarhus Univ Hosp Brendstrupgaardsvej Aarhus Denmark N Denmark
Citazione:
H.E. Botker et al., "Electromechanical mapping for detection of myocardial viability in patients with ischemic cardiomyopathy", CIRCULATION, 103(12), 2001, pp. 1631-1637

Abstract

Background-We evaluated the ability of electromechanical mapping of the left ventricle to distinguish between nonviable and viable myocardium in patients with ischemic cardiomyopathy. Methods and Results-Unipolar Voltage amplitudes and local endocardial shortening were measured in 31 patients (mean +/- SD age, 62 +/-8 years) with ischemic cardiomyopathy (ejection fraction, 30 +/-9%). Dysfunctional regions, identified by 3D echocardiography, were characterized as nonviable when PET revealed matched reduction of perfusion and metabolism and as viable when perfusion was reduced or normal and metabolism was preserved. Mean unipolar voltage amplitudes and local shortening differed among normal, nonviable, and viable dysfunctional segments. Coefficient of variation for local shortening exceeded differences between groups and did not allow distinction between normal and dysfunctional myocardium. Optimum nominal discriminatory unipolar voltage amplitude between nonviable and viable dysfunctional myocardium was 6.5 mV, but we observed a great overlap between groups. Individual cutoff levels calculated as a percentage of electrical activity in normalsegments were more accurate in the detection of viable dysfunctional myocardium than a general nominal cutoff level. The optimum normalized discriminatory value was 68%. Sensitivity and specificity were 78% for the normalized discriminatory value compared with 69% for the nominal value (P<0.02). Conclusions-Endocardial ECG amplitudes in patients with ischemic cardiomyopathy display a wide scatter, complicating the establishment of exact nominal values that allow distinction between viable and nonviable areas. Individual normalization of unipolar voltage amplitudes improves diagnostic accuracy. Electroanatomic mapping may enable identification of myocardial viability.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 04:57:25