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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Correlation of vectorcardiogram and electrocardiogram with coronary arteriogram
G B Lee1, W J Wilson, K Amplatz
1Department of Medicine, St. Paul Ramsey Hospital, University of Minnesota, Minneapolis, Minnesota, USA.
Insights
Vectorcardiography (VCG) detected more heart attacks than electrocardiography (ECG). VCG identified infarction in 67 patients, correlating with coronary artery disease in most cases, while ECG missed several.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Coronary heart disease (CHD) diagnosis relies on correlating clinical findings with imaging.
- Electrocardiography (ECG) and vectorcardiography (VCG) are non-invasive methods to assess cardiac electrical activity.
- Coronary arteriography provides definitive visualization of coronary artery stenosis.
Purpose of the Study:
- To compare the diagnostic accuracy of VCG and ECG in detecting myocardial infarction (MI) in patients with suspected CHD.
- To correlate VCG and ECG findings of MI with coronary arteriography results.
Main Methods:
- Prospective study of 100 patients with suspected CHD.
- Utilized vectorcardiography (VCG), electrocardiography (ECG), and coronary arteriography for diagnosis.
- Analyzed VCG and ECG evidence of anterior, diaphragmatic, and posterior infarction.
Main Results:
- VCG identified infarction in 67 patients (anterior: 28, diaphragmatic: 27, posterior: 12).
- Correlation with coronary artery disease was high for VCG-detected anterior (26/28) and diaphragmatic (25/27) MIs.
- ECG detected fewer MIs compared to VCG, particularly posterior infarction (2/12).
- Significant coronary artery narrowing or obstruction was found in most VCG-positive cases.
- 15 patients had coronary obstruction without infarction, and 13 had infarction with non-total obstruction.
Conclusions:
- VCG appears more sensitive than ECG for detecting myocardial infarction in suspected CHD.
- VCG findings correlate well with significant coronary artery disease.
- Discrepancies between infarction and coronary obstruction highlight the complexity of CHD diagnosis.
Abstract:
One hundred patients with suspected coronary heart disease were studied by vectorcardiography (VCG), electrocardiography (ECG), and coronary arteriography. Twenty-eight patients had VCG evidence of anterior infarction; 26 of this group had severe narrowing or obstruction of the left anterior descending branch. Five did not have anterior infarction by ECG. Twenty-seven patients had VCG evidence of diaphragmatic infarction; 25 of this group had severe narrowing of the right coronary artery or the left circumflex branch or both. Six of the 27 did not have ECG evidence of diaphragmatic infarction. Twelve patients had VCG evidence of posterior infarction whereas it was detected by ECG in only two. Only six of the 12, however, had severe narrowing of the nutrient arteries to the posterobasal part of the myocardium. Thirteen patients with infarction had severe narrowing but not total obstruction of a coronary artery. On the other hand, 15 patients had total obstruction of a major coronary vessel without actual infarction.
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