Effect of increased left ventricle mass on ischemia assessment
in electrocardiographic signals: rabbit isolated heart study

J 2017

Effect of increased left ventricle mass on ischemia assessment in electrocardiographic signals: rabbit isolated heart study

RONZHINA, M., Veronika OLEJNÍČKOVÁ, Tibor STRAČINA, Marie NOVÁKOVÁ, O. JANOUSEK et. al.

Basic information

Original name

Effect of increased left ventricle mass on ischemia assessment in electrocardiographic signals: rabbit isolated heart study

Authors

RONZHINA, M. (203 Czech Republic), Veronika OLEJNÍČKOVÁ (203 Czech Republic, belonging to the institution), Tibor STRAČINA (703 Slovakia, belonging to the institution), Marie NOVÁKOVÁ (203 Czech Republic, guarantor, belonging to the institution), O. JANOUSEK (203 Czech Republic), J. HEJC (203 Czech Republic), J. KOLAROVA (203 Czech Republic), Miroslava HLAVÁČOVÁ (703 Slovakia, belonging to the institution) and Hana PAULOVÁ (203 Czech Republic, belonging to the institution)

Edition

BMC Cardiovascular Disorders, London, Biomed Central Ltd, 2017, 1471-2261

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.812

RIV identification code

RIV/00216224:14110/17:00097870

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1186/s12872-017-0652-9

UT WoS

000406953000001

Keywords in English

Myocardial ischemia detection; Increased left ventricular mass; Electrogram; ROC analysis; Isolated heart; Rabbit

Abstract

V originále

Background: Detailed quantitative analysis of the effect of left ventricle (LV) hypertrophy on myocardial ischemia manifestation in ECG is still missing. The associations between both phenomena can be studied in animal models. In this study, rabbit isolated hearts with spontaneously increased LV mass were used to evaluate the effect of such LV alteration on ischemia detection criteria and performance. Methods: Electrophysiological effects of increased LV mass were evaluated on sixteen New Zealand rabbit isolated hearts under non-ischemic and ischemic conditions by analysis of various electrogram (EG) parameters. To reveal hearts with increased LV mass, LV weight/heart weight ratio was proposed. Standard paired and unpaired statistical tests and receiver operating characteristics analysis were used to compare data derived from different groups of animals, monitor EG parameters during global ischemia and evaluate their ability to discriminate between unchanged and increased LV as well as non-ischemic and ischemic state. Results: Successful evaluation of both increased LV mass and ischemia is lead-dependent. Particularly, maximal deviation of QRS and area under QRS associated with anterolateral heart wall respond significantly to even early phase (the 1st-3rd min) of ischemia. Besides ischemia, these parameters reflect increased LV mass as well (with sensitivity reaching approx. 80%). However, the sensitivity of the parameters to both phenomena may lead to misinterpretations, when inappropriate criteria for ischemia detection are selected. Particularly, use of cut-off-based criteria defined from control group for ischemia detection in hearts with increased LV mass may result in dramatic reduction (approx. 15%) of detection specificity due to increased number of false positives. Nevertheless, criteria adjusted to particular experimental group allow achieving ischemia detection sensitivity of 89-100% and specificity of 94-100%, respectively. Conclusions: It was shown that response of the heart to myocardial ischemia can be successfully evaluated only when taking into account heart-related factors (such as LV mass) and other methodological aspects (such as recording electrodes position, selected EG parameters, cut-off criteria, etc.). Results of this study might be helpful for developing new clinical diagnostic strategies in order to improve myocardial ischemia detection in patients with LV hypertrophy.

Links

MUNI/A/1205/2016, interní kód MU

Name: Příspěvek biochemických metodik ke studiu molekulární podstaty vybraných patologických stavů a onemocnění (Acronym: mopopas)

Investor: Masaryk University, Category A

MUNI/A/1355/2016, interní kód MU

Name: Kardiovaskulární systém očima molekulární fyziologie

Investor: Masaryk University, Category A

Citovat

RONZHINA, M., Veronika OLEJNÍČKOVÁ, Tibor STRAČINA, Marie NOVÁKOVÁ, O. JANOUSEK, J. HEJC, J. KOLAROVA, Miroslava HLAVÁČOVÁ and Hana PAULOVÁ. Effect of increased left ventricle mass on ischemia assessment in electrocardiographic signals: rabbit isolated heart study. BMC Cardiovascular Disorders. London: Biomed Central Ltd, 2017, vol. 17, No 216, p. 1-11. ISSN 1471-2261. Available from: https://dx.doi.org/10.1186/s12872-017-0652-9.

@article{1392206,
   author = {Ronzhina, M. and Olejníčková, Veronika and Stračina, Tibor and Nováková, Marie and Janousek, O. and Hejc, J. and Kolarova, J. and Hlaváčová, Miroslava and Paulová, Hana},
   article_location = {London},
   article_number = {216},
   doi = {http://dx.doi.org/10.1186/s12872-017-0652-9},
   keywords = {Myocardial ischemia detection; Increased left ventricular mass; Electrogram; ROC analysis; Isolated heart; Rabbit},
   language = {eng},
   issn = {1471-2261},
   journal = {BMC Cardiovascular Disorders},
   title = {Effect of increased left ventricle mass on ischemia assessment in electrocardiographic signals: rabbit isolated heart study},
   volume = {17},
   year = {2017}
}

TY  - JOUR
ID  - 1392206
AU  - Ronzhina, M. - Olejníčková, Veronika - Stračina, Tibor - Nováková, Marie - Janousek, O. - Hejc, J. - Kolarova, J. - Hlaváčová, Miroslava - Paulová, Hana
PY  - 2017
TI  - Effect of increased left ventricle mass on ischemia assessment in electrocardiographic signals: rabbit isolated heart study
JF  - BMC Cardiovascular Disorders
VL  - 17
IS  - 216
SP  - 1-11
EP  - 1-11
PB  - Biomed Central Ltd
SN  - 14712261
KW  - Myocardial ischemia detection
KW  - Increased left ventricular mass
KW  - Electrogram
KW  - ROC analysis
KW  - Isolated heart
KW  - Rabbit
N2  - Background: Detailed quantitative analysis of the effect of left ventricle (LV) hypertrophy on myocardial ischemia manifestation in ECG is still missing. The associations between both phenomena can be studied in animal models. In this study, rabbit isolated hearts with spontaneously increased LV mass were used to evaluate the effect of such LV alteration on ischemia detection criteria and performance. Methods: Electrophysiological effects of increased LV mass were evaluated on sixteen New Zealand rabbit isolated hearts under non-ischemic and ischemic conditions by analysis of various electrogram (EG) parameters. To reveal hearts with increased LV mass, LV weight/heart weight ratio was proposed. Standard paired and unpaired statistical tests and receiver operating characteristics analysis were used to compare data derived from different groups of animals, monitor EG parameters during global ischemia and evaluate their ability to discriminate between unchanged and increased LV as well as non-ischemic and ischemic state. Results: Successful evaluation of both increased LV mass and ischemia is lead-dependent. Particularly, maximal deviation of QRS and area under QRS associated with anterolateral heart wall respond significantly to even early phase (the 1st-3rd min) of ischemia. Besides ischemia, these parameters reflect increased LV mass as well (with sensitivity reaching approx. 80%). However, the sensitivity of the parameters to both phenomena may lead to misinterpretations, when inappropriate criteria for ischemia detection are selected. Particularly, use of cut-off-based criteria defined from control group for ischemia detection in hearts with increased LV mass may result in dramatic reduction (approx. 15%) of detection specificity due to increased number of false positives. Nevertheless, criteria adjusted to particular experimental group allow achieving ischemia detection sensitivity of 89-100% and specificity of 94-100%, respectively. Conclusions: It was shown that response of the heart to myocardial ischemia can be successfully evaluated only when taking into account heart-related factors (such as LV mass) and other methodological aspects (such as recording electrodes position, selected EG parameters, cut-off criteria, etc.). Results of this study might be helpful for developing new clinical diagnostic strategies in order to improve myocardial ischemia detection in patients with LV hypertrophy.
ER  -

RONZHINA, M., Veronika OLEJNÍČKOVÁ, Tibor STRAČINA, Marie NOVÁKOVÁ, O. JANOUSEK, J. HEJC, J. KOLAROVA, Miroslava HLAVÁČOVÁ and Hana PAULOVÁ. Effect of increased left ventricle mass on ischemia assessment in electrocardiographic signals: rabbit isolated heart study. \textit{BMC Cardiovascular Disorders}. London: Biomed Central Ltd, 2017, vol.~17, No~216, p.~1-11. ISSN~1471-2261. Available from: https://dx.doi.org/10.1186/s12872-017-0652-9.

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