Key result
Catheter-based electromechanical mapping correlated with regional wall motion scores by echocardiography, showing decreased voltage and shortening signals in segments with impaired function (P=0.0001).
Why the study?
Does catheter-based electromechanical mapping correlate with regional wall motion assessed by echocardiography in patients with coronary artery disease?
Observational (n=74)
Does catheter-based electromechanical mapping correlate with regional wall motion assessed by echocardiography in patients with coronary artery disease?
p-value: p=0.0001
Catheter-based electromechanical mapping correlates significantly with regional wall motion scores assessed by echocardiography, demonstrating proportional decreases in voltage and shortening signals in segments with impaired function.
Supports electromechanical mapping as echo correlate in CAD; hypothesis-generating and should not yet change practice.
Recent studies using a nonfluoroscopic three-dimensional left ventricular mapping system showed considerable changes in voltage potentials and mechanical activity detected in ischemic and infarcted myocardial regions with mechanical dysfunction. This study examined the electromechanical characteristics in relation to regional wall motion assessed by echocardiography in patients with coronary artery disease. A 12-segment model of mapping (apical, mid, basal of septal, anterior, lateral, and inferior/posterior segments) was compared to echo wall motion score in 74 patients (836 segments). Unipolar voltage and local endocardial shortening signals were distinguished according to graded echo segmental rest scores (0 = normal, 1 = mild hypokinesis, 2 = moderate hypokinesis, 3 = severe hypokinesis, 4 = akinesis). Results show a significant difference in voltage potentials and shortening values in groups distinguished according to echocardiography motion score. The average voltage potentials and shortening values were highest in myocardial segments with normal or slightly reduced contractility and lowest in myocardial segments with moderate to severely impaired contractility scores (voltage: 12.3 +/- 5.0, 12.1 +/- 5.3, 10.7 +/- 5.4, 8.7 +/- 3.9, 7.1 +/- 3.0 mV, P = 0.0001; local shortening: 9.7 +/- 6.5, 8.4 +/- 5.9, 8.0 +/- 5.4, 5.6 +/- 6.3, 5.1 +/- 4.6%, P = 0.0001 in regions with segmental scores of 0, 1, 2, 3, 4 by echo, respectively). Using receiver-operating curve calculations, the area under the curve was 0.72 +/- 0.06 (voltage) and 0.67 +/- 0.05 (local shortening) without a significant difference between the two curves. The 90% thresholds for defining preserved vs. impaired contractility were 12.8 and 5.6 mV for voltage and 12.6% and 1.6% for local shortening. We conclude that electromechanical mapping correlates with regional changes in wall motion scores assessed by echo, showing a gradual proportional decrease in measured voltage and shortening signals in segments with impaired function.
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Kornowski et al. (2001) conducted an observational in Coronary artery disease (n=74). Catheter-based electromechanical mapping vs. Transthoracic echocardiography was evaluated on Voltage potentials and local endocardial shortening signals across echocardiography motion scores (p=0.0001). Catheter-based electromechanical mapping correlated with regional wall motion scores by echocardiography, showing decreased voltage and shortening signals in segments with impaired function (P=0.0001).