PISA: a noninvasive method in detection and quantification of acid-induced myocardial infarction in dogs

Phase invariant signature algorithm (PISA), a new noninvasive technique, was used in the detection and quantification of acid-induced myocardial damage in anesthetized dogs. The diagnostic capabilities of this method were compared with those of conventional electrocardiogram and biochemical markers, MB-creatine phosphokinase (MB-CPK) and lactic dehydrogenase (LDH1). Myocardial damage of varying degree was induced by injecting diluted sulphuric acid (0.01 to 0.10 ml) into the free wall of the left ventricle. Conventional ECG, wideband ECG for PISA analysis, blood samples for LDH1, and MB-CPK were taken before and after 15, 30, 60, and 90 min of acid injection. The heart was removed at the end of 90 min for estimation of myocardial damage. PISA Index increased within 10-15 min of acid injection and remained elevated for the duration of the experiment (90 min). The increase in the PISA index was directly related to the extent of myocardial damage and the amount of acid injected. Although the conventional electrocardiogram detected large myocardial damage, it was unable to detect small myocardial damage. Also, most of initial change in conventional ECG with large myocardial damage disappeared within 90 min, while the PISA index was still elevated to the maximum level. The MB-CPK was not detected before or after myocardial damage. There was no significant change in the LDH1 at any time after myocardial infarction. These results suggest that the PISA technique is superior to the conventional ECG and the biochemical markers and would be a valuable diagnostic tool in the detection and quantification of incipient as well as advanced myocardial infarction.