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Isointegral body surface maps and left ventricular hypertrophy in post-infarction heart failure patients
1Victor Babes, University of Medicine and Pharmacy Department of Pathophysiology Timisoara Romania. ioanamozos@yahoo.de
Insights
Isointegral body surface maps can evaluate left ventricular hypertrophy (LVH) in patients with heart failure after myocardial infarction. This non-invasive method shows significant differences in electrical activity, aiding in LVH assessment.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Left ventricular hypertrophy (LVH) is a common complication following myocardial infarction, impacting heart failure prognosis.
- Traditional assessment of LVH relies on echocardiography, which may have limitations in certain patient populations.
- Non-invasive electrophysiological mapping offers a potential complementary approach to evaluate cardiac structural changes.
Purpose of the Study:
- To investigate the utility of isointegral body surface mapping in assessing left ventricular hypertrophy (LVH) in patients with chronic heart failure post-myocardial infarction.
- To determine if specific parameters from isointegral maps correlate with the degree of LVH measured by echocardiography.
Main Methods:
- A cohort of 32 patients with stable chronic heart failure post-myocardial infarction underwent 64-electrode body surface mapping (isointegral QRS, QRST, ST, and STT maps).
- Echocardiography was performed concurrently to assess left ventricular hypertrophy (LVH).
- Statistical analysis compared mapping parameters between patients with and without LVH.
Main Results:
- Fifty percent of patients (16 out of 32) exhibited LVH based on echocardiography.
- Isointegral map parameters, including QRS maxima/minima and ST minima, showed statistically significant differences in patients with LVH.
- Isointegral QRS and QRST maxima demonstrated strong correlations with left ventricular mass (r=0.73 and 0.81, respectively).
Conclusions:
- Isointegral body surface mapping is a valuable tool for evaluating LVH in post-myocardial infarction heart failure patients.
- Key parameters like isointegral QRS and QRST maps, particularly in the second third of the QRS complex, and isointegral ST minima are highly sensitive indicators of LVH.
- This technique offers a promising non-invasive method to complement existing diagnostic approaches for LVH.
Aim:
Ventricular remodeling causes left ventricular hypertrophy (LVH) in myocardial infarction patients. We hypothesized that LVH can be evaluated using isointegral body surface maps.
Methods:
Thirty-two patients with post-infarction stable chronic heart failure underwent a 64-electrode body surface mapping (isointegral QRS, QRST, ST and STT maps) and 2-D echocardiography.
Results:
LVH was present in 16 of them (50%) according to 2D-echocardiography. Isointegral maxima increased and the minima were more negative in patients with LVH, and the differences were statistically significant for: isointegral QRS maxima (35±16 versus 60±21 mV.ms, p=0.0085) and minima (25±15 versus 69±14 mV.ms, p=0.0067), isointegral maxima and minima in the second third of the QRS complex, isointegral QRST minima and isointegral ST minima (5±2 versus 10±4 mV.ms, p=0.0026). Isointegral multipolar maps prevalence was increased in patients with LVH (75% versus 50%). Isointegral QRS and QRST maxima correlated best with the left ventricular mass (r=0.73 and 0.81).
Conclusion:
Body surface mapping is a useful method for the evaluation of patients with left ventricular hypertrophy in post-infarction heart failure. The most sensitive parameters are: isointegral QRS maxima and minima, especially in the second third of the QRS complex, isointegral QRST maps (minima, maxima and multipolarity) and isointegral ST minima.
