Key result
CineECG accurately pointed to the area at risk in coronary occlusions, including LCX occlusions where standard ECG showed small or no ST abnormalities.
Why the study?
The study aimed to visualize and quantify injury vectors using the CineECG in representative examples of STEMI and STEMI-equivalent ECGs.
Does CineECG accurately localize the area at risk in STEMI and STEMI-equivalent acute coronary syndromes?
Observational
Does CineECG accurately localize the area at risk in STEMI and STEMI-equivalent acute coronary syndromes?
CineECG may be a useful tool for localizing ischemia in STEMI and STEMI-equivalent acute coronary syndromes, particularly in LCX occlusions where standard ECG is often non-diagnostic.
May aid area-at-risk localization when standard ECG is nondiagnostic; leaves open prospective validation before clinical adoption.
AIM OF THE STUDY: In this proof of concept study we aimed to visualize and quantify the injury vectors using the CineECG in representative examples of ST elevation acute myocardial infarction (STEMI) and STEMI-equivalent electrocardiograms (ECG's). For this purpose ECG's were selected with different ST deviation patterns in acute anterior wall, inferior or posterolateral wall infarctions. METHODS: The ST-amplitudes of the individual leads were measured between J-point and 60 ms after the J-point. These data were used to compute the direction and size (i.e. ST-amplitudes) of the injury vectors of the respective STEMI (equivalent)'s and displayed in the frontal, transverse and sagittal view. The relative contribution of the ST vector was computed for each axis (X,Y,Z) and per view using the length of the projected ST vector on the respective plane. RESULTS: The injury vectors accurately pointed to the area at risk in either proximal, mid or distal occlusions of the respective coronary arteries. Moreover in LCX occlusions, where no or small ST abnormalities in the standard ECG were present, the CineECG was found to be capable in pointing towards the ischemic area. Especially the visualization of the ST-vector in the sagittal plane was found to be contributing. CONCLUSIONS: These findings suggest that the CineECG could become a useful additional tool to support the clinician. Moreover our preliminary findings suggest that CineECG may be more capable in detecting ischemic changes in situations where the ECG is not supportive, such as in LCX occlusions. Further studies in patient cohorts are needed to confirm these observations.
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Gorgels et al. (2023) conducted an observational in ST-elevation (equivalent) acute coronary syndromes. CineECG vs. Standard ECG was evaluated on Visualization and quantification of injury vectors pointing to the area at risk. CineECG accurately pointed to the area at risk in coronary occlusions, including LCX occlusions where standard ECG showed small or no ST abnormalities.
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