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The value of body surface potential maps in detecting abnormal ventricular wall motion
1Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Republic of China.
Insights
Body surface potential maps (BSPMs) can detect abnormal ventricular wall motion in coronary artery disease (CAD) patients. Early reversal in BSPMs correlates with wall motion abnormalities, aiding in diagnosing CAD-related issues.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Coronary artery disease (CAD) frequently leads to ventricular wall motion abnormalities.
- Body surface potential maps (BSPMs) offer a non-invasive method to assess cardiac electrical activity.
- Expanding the clinical utility of BSPMs in CAD requires understanding their relationship with mechanical function.
Purpose of the Study:
- To investigate the correlation between abnormal ventricular wall motion and BSPMs in patients with confirmed CAD.
- To evaluate the diagnostic performance of BSPMs in identifying specific coronary artery lesions based on wall motion abnormalities.
Main Methods:
- Analysis of BSPMs and left ventriculograms in 98 consecutive patients with angiographically proven CAD.
- Assessment of the timing of potential maximum and minimum during ventricular depolarization.
- Calculation of sensitivity, specificity, and predictive values for detecting LAD, LCX, RCA, and multi-vessel CAD.
Main Results:
- 50% of patients exhibited wall motion abnormalities on ventriculography.
- 56.1% of patients displayed abnormal "early reversal" in BSPMs during early ventricular depolarization (p < 0.001).
- Abnormal "early reversal" in BSPMs showed a strong association with abnormal ventricular wall motion.
Conclusions:
- Abnormal "early reversal" in BSPMs serves as a reliable indicator of abnormal ventricular wall motion in CAD.
- BSPMs demonstrate high sensitivity (85%) and specificity (80%) for detecting LAD lesions, including those with multi-vessel involvement.
Abstract:
In an effort to enlarge the clinical application of body surface potential maps (BSPMs), the authors studied the relationship between abnormal ventricular wall motion and BSPMs in 98 consecutive patients with angiographically proven coronary artery disease (CAD). Forty-nine of the patients (50%) had wall motion abnormalities as seen on single-plane left cine ventriculograms. During early ventricular depolarization, normal BSPMs have a potential maximum that is greater than the absolute value of the potential minimum; this reverses in late depolarization such that the absolute value of the potential minimum is the greater. The patients showed a significantly early reversal (p less than 0.001), and 55 (56.1%) had abnormal "early reversal" BSPMs. This abnormal "early reversal" is closely related to abnormal ventricular wall motion. Using it as an indicator of abnormal wall motion, the authors obtained the sensitivity, specificity, positive predictive value, and negative predictive value of the following conditions: LAD lesions, LCX, RCA, LAD and RCA lesions, LAD and LCX, and three-vessel disease, and for all patients. A relatively high sensitivity (85%) and specificity (80%) was found in patients with LAD lesions only or multivessel lesions in addition to LAD lesions.