Did the global myocardial ischemia produce an influence on high-frequency QRS potentials?
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Biomedical subjects
Publications and source records attributed to Yasushi Terada.
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OBJECTIVES: We have previously developed current vector maps of tangential components on the magnetocardiogram (MCG) to obtain cardiac current distribution images. The present study was conducted to detect repolarization abnormalities in patients with cardiomyopathy using the current vector map. SUBJECTS AND METHODS: Thirteen patients with cardiomyopathy (nine males and four females aged 7-16 years, mean, 11.5 +/- 3.1 years, +/- SD), and 15 age- and sex-matched normal subjects were studied. Normal components (Bz) of MCG were measured at rest with a multi-channel superconducting quantum interface device (SQUID) system, and differentiated in the tangential direction to obtain current vector maps. Homogeneity of current in the heart during repolarization was investigated. The direction of the maximum current vector was also calculated in each case. RESULTS: In all normal subjects, the current vector consistently showed a left downward direction on the frontal chest plane during the repolarization process. On the other hand, 8 out of 13 patients with cardiomyopathy showed different patterns; four of these patients showed multi-dipoles, and the other four showed a shift in the current vector direction. One of the eight cases showed no abnormality on electrocardiogram (ECG). CONCLUSIONS: Repolarization process in patients with cardiomyopathy was apparently different from those in normal subjects on the current vector map. It was easy to visualize the repolarization process as a projection to the frontal plane, including regional abnormalities, by the current vector maps, which might be more useful for early detection of repolarization abnormalities than ECG.
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We tried to visualize normal atrial excitatory process by magnetocardiogram (MCG) measured from both anterior chest and back using our newest multi-channel SQUID system. Twenty normal subjects were studied. After measuring the normal (B(z)) component of the magnetic field, we constructed an isomagnetic and vector arrow map from spatial derivatives of the normal (B(z)) component in the tangential direction. By the MCG measurement from the anterior chest, current arrows were recognized in the right upper portion which were directed to the left lower from the beginning of the P wave to the P-wave peak. By the measurement from the back, current arrows were able to be visualized in the right to middle upper portion which were directed to the left or left lower just before the P-wave peak. We conclude that we successfully recognized the right atrial excitation and its spread to the left atrium and observed the time course of normal atrial excitatory process by the MCG measurement from not only anterior chest but also back using 64-channel SQUID system.
The authors have recently reported on the usefulness of the isointegral mapping technique using magnetocardiography (MCG) for the diagnosis of adult ischemic heart disease. This study evaluated myocardial ischemia in patients with Kawasaki disease (KD). The ischemia has been considered difficult to diagnose with a standard ECG. The study included 32 patients (age 3 +/- 22 years, mean 12.9 +/- 4.1 years, +/- SD) with a history of KD and 21 age-matched healthy children. Coronary arterial lesions were present in 13 patients of the KD group, MCG was carried out at rest with a multichannel superconducting quantum interference device (SQUID) system. The integral value was computed for each channel and isointegral maps were constructed during depolarization and repolarization processes. In all subjects of the control group, the integral value of repolarization was higher than that of depolarization and the isointegral map of these two processes showed similar patterns. However, the integral value of repolarization in four cases with KD (one with a history of myocardial infarction, two with a stenotic lesion in the left coronary artery, one with an aneurysmal and stenotic lesion in the right coronary artery) was lower than that of depolarization, and abnormal patterns were evident in the isointegral map. All but the case with myocardial infarction showed only mild abnormalities or almost normal on the ECG. Although sensitivity of the method for detection of myocardial ischemia was not fully assessed because of the small number of cases with significant coronary arterial stenosis, noninvasive isointegral mapping technique using the MCG could be useful for evaluation of myocardial ischemia in patients with KD.