A method for the diagnosis of ischemic damage to the heart muscle

 

The invention relates to medicine, cardiology. Patients continuously, long-term ECG record. Analyzing the deviation from the contour points of the beginning and end of electroneutral plot repolarization curve. The absolute values of the deviations of these points in mV of each cardiac contraction is multiplied by a coefficient snapshot conductivity (k). k is calculated as the ratio 1mV to the magnitude of the amplitude of the RS of the same cardiac cycle. Certain torregiani values of the analyzed points diagnose ischemic damage to the heart muscle. The method allows to diagnose myocardial ischemia taking into account the physiological and external changes. 3 Il.

The invention relates to medicine, namely to methods electrocardiographic diagnosis and assess the degree of ischemic damage to the heart muscle.

A known method for the diagnosis of ischemic damage to the heart muscle, which is performed through a continuous, for example, the daily record ECG in real time and its memorization and subsequent playback by assessing the deviation from the contour of the pixel values of j and i, the beginning and end of electrometer is a 61 In 5/0468, 26.01.1993.

At that, the registered potential on the body surface is formed as the sum of the mutual influences active intracardiac current sources and changes of intracellular potentials, low ongoing area of heterogeneous structure of the lungs, high muscle conducted education and the influence of the surface section of the body of air in a specific point of attachment of the electrodes and additional sources of errors introduced hardware, which is expressed in limited frequency bands of the transmission amplifier and insufficient sample rates and bit depth than do not take into account temporary daily biological cycle and the full range of physiological and phenotypic changes during registration cardiomegaly.

As a result, in the conventional method of diagnosis at check cardiomegaly changes the amplitude as high-gradient components of the PQRST complex, and low-amplitude plots of cardiomegaly. Therefore, the amplitude value of a particular point of the PQRST complex for the foregoing reasons, it may be a variable value.

The use of standard calibration pulse is equal to 1mV, you can compare the amplitude value of electrocardiograms, i registered, - points at the beginning and end electrically neutral site repolarization curve complex RST the ST segment of the electrocardiogram, diagnose ischemic damage to the heart muscle, not taking into account the amplitude of the oscillations. Thereby by a known method to accurately judge ischemic damage to the heart muscle is not possible, since only the absolute value of cardiomegaly without regard to their level and all sums hardware, physiological and phenotypic changes during its registration.

The basis of the invention is to provide a method of diagnosis of ischemic damage to the heart muscle, which would take into account all contributions hardware, physiological and external changes during registration cardiomegaly by using the correction coefficient k than would have increased the accuracy of diagnosis of ischemic damage.

This task is solved in that in the known method for the diagnosis of ischemic damage to the heart muscle, which is performed through a continuous, for example, the daily record ECG in real time and its memorization and subsequent playback capability, by assessing deviations of amplexa RST the ST segment of the electrocardiogram, according to the invention the recorded absolute values in mV deviations from the contour points j and i each cardiac contraction corrects by multiplying by a factor of torque conductivity k, is equal to the ratio 1mV to the magnitude of the amplitude of the RS in mV of the same heart beat, and when torregiani the pixel values of j and i +0,20 mV, in the case of elevation of the ST segment, and more -0,10 mV, in the case of ST-segment depression, diagnosed ischemic damage to the heart muscle.

Thus, using the adjustment factor torque conductivity k, is equal to the ratio 1mV to the magnitude of the amplitude of the RS in mV of each individual heart beat, and multiplying by him absolute value reported in mV deviations of the points j and i of the ST segment from the contours obtained torregiani values of deviations from the contours of these points, considering that for each heartbeat of the value of the coefficient k is a value of its own and takes into account the whole amount of time, surface, spatial, and electrical events of the heart, and whose values are already diagnosed ischemic damage to the heart muscle.

In the following the invention is illustrated by the example of his particular job and drawings, in which: Fig.1 pokarekare one patient presented a number of amplitude values in a single heart beat, taken at different times of the daily record; Fig. 2 shows the same graph with the adjusted amplitude values of the deviations and images the same heart rate, are presented in absolute and adjusted; Fig. 3 shows the amplitude values of the deviations recorded for the three patients with different anatomical structure of the body, where next to each heart contraction shows the absolute and adjusted in this way the values of the deviations from the contour points j and i.

The method is as follows.

In this particular case portable cardioregulatory with Autonomous power source are recording the electrocardiogram during the day. After conducting such recordings make a reset of the recorded electrocardiogram on your computer's hard drive in a pre-prepared map of the patient for subsequent playback and analysis.

Diagnosis of ischemic damage to the heart muscle is produced by evaluating the deviation from the contour of the pixel values of j and i, the beginning and end of electroneutral plot repolarization curve of the RST complex ST segment of each cardiac contraction recorded electrocardiogram.

Health the ST segment, namely, the deviation from the contour of the pixel values of j and i, the beginning and end of electroneutral plot repolarization of the heart muscle, ranging from -0,10 mV to +0,20 mV.

As seen on electrocardiograms one cardiac contraction, shown in Fig.1, the absolute values of the deviations from the contour points j and i of the ST segment at different times of the day will be different, and for fragment 5 is logged ischemic damage to the heart muscle.

Therefore, according to the invention, the recorded absolute values in mV deviations of the points j and i of the ST segment from the contour of each of the RST complex of the electrocardiogram shown in Fig.1, taken into account for the diagnosis only after correction by multiplying these values by the correction factor torque conductivity k=1mV/ARSwhere; ARS- amplitude plot for RS accrued heart of the complex is expressed in mV.

And already on the adjusted values of the deviations of the points j and i, shown in Fig.2, it is seen that for fragment 5 ischemic damage to the heart muscle is not confirmed.

In the case of multiple patients with different anatomical structure of the body by multiplying the absolute deviations from the contour points j and i, equal -0,10 and -0,09 mV, coefficient and deviation +0.01 and +0,10 mV by a factor of k=0.75 to for the third patient, obtain the total deviation from the contour points j and i, equal -0,03 -0,02 and mV, +0,03 +0,05 mV and +0,007 +0,075 mV, for the third patient, as shown on the electrocardiogram of Fig.3, indicating the absence of the ischemic lesion of the cardiac muscle in all patients. While taking into account their absolute values, without taking into account the correction factor torque conductivity k, 'd have to say ischemic damage to the heart muscle in the first patient.

Thus, accounting for the whole range of physiological and phenotypic changes during registration cardiomegaly, through the use of the correction factor torque conductivity k, increases the reliability of the diagnosis of ischemic damage of the heart muscle in various real conditions of registration of the electrocardiogram.

In addition, development on this way for each cardiographic lead tolerance will lead to a total system standardized assessments, will allow you to operate on shared values in the interpretation of coronary heart disease, to quantify the magnitude of ischemic damage to the heart muscle.

Formularizing long-term recording of the electrocardiogram in real time and its memorization and subsequent playback by assessing deviations from the contour of the pixel values of j and i - the beginning and end of electroneutral plot repolarization curve of the RST complex ST segment of the electrocardiogram, characterized in that the recorded absolute values in mV deviations from the contour points j and i each cardiac contraction corrects by multiplying by a factor of instantaneous conductance, equal to the ratio 1mV to the magnitude of the amplitude of the RS in mV of the same heart beat, and when torregiani the pixel values of j and i +0,20 mV in the case of elevation of the ST segment, and more -0,10 mV in the case of ST-segment depression, diagnosed ischemic damage to the heart muscle.

 

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