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P1-13 Image ECG for coronary heart disease diagnosis
$48
Abstracts/International Journal of Cardiology 97 Suppt 2 (2004) S 1 ~ 7 5
appreciation by computing and displaying techniques. In this research, we combine the frontal plane and horizontal plane of the traditional 12 lead electric cardiac signals into image format representation. 42 patients, age from 39 to 72, represented with acute corona~2¢ syndi-ome were em-olled in our research. We used the pattern of IECG to identify the symptoms of ACS and compared with other clinical data, history, ECG report and myocardium enzyme, we use the volume integration of the IECG to calculate the Q wave volume and S T T change. Results: By ROC analysis, we calculate the sensitivity and the specificity of frontal plane are 64% and 82%, and horizontal plane are 68% and 86%. The physicians can thus have an overall integral view over a plentiful number of cardiac signals and thereby make diagnosis about the heart conditions of the patient more easily.
apDeciation by computing and displaying techiliques. In tNs ~esearch, we combine the frontal plane and horizontal plane of the traditional 12qead electric cardiac signals into image fomlat representation. 214 patients, age from 35 to 90, represented with coronary heart disease were emolled in our research. We used the pattern of IECG to identify the symptoms of old CHD and compared with other clinical data, history, ECG report and myocardium enzyme, we use the volume integration of the IECG to calculate the ratio of Q wave volume and QR wave volume. Results: By ROC analysis, we calculate the sensitivity and the specificity of frontal plane are 95% and 100%, and horizontal plane are 92.3% and 100%. The physicians can thus have an overall integral view over a plentiful number of cardiac signals and thereby make diagnosis about the heart conditions of the patient more easily.
P1-12 METABOLIC SYNDROME (MS) IS ASSOCIATED WITH M U L T I P L E - V E S S E L S C O R O N A R Y A R T E R Y D I S E A S E (CAD) IN END STAGE RENAL DISEASE (ESRD) PATIENTS C O M P L I C A T E D W I T H A C U T E C O R O N A R Y S Y N D R O M E (ACS)
P1-14 IN-YIVO CHARACTERIZATION OF CARDIOVASCULAR DISEASE
Han Hsiang Chen, Chih Jen Wu, Yi~Chou Chen, Chih Sheng Tsal, Fung J. Lin, Hung I. Yeh. Department of Internal Medicine, Mackay
Memorial Hospital, Taipei, Taiwan Background: People with MS or ESRD are known at increased risk for developing CAD. However, whether in patients with ESRD the Desence of MS adds additional risk for CAD remained unclear. Methods: We retrosFec tively examined the 5 components of M S, includ ing blood pressure (> 130/85 nmffIg), fasting glucose (> 110 mg/dL), fasb ing triglycerides (> 150 mg/dL), high density lipoprotein (HDL) choles terol level (men <40 mg/dL; women <50 mg/dL), and abdominal obesity (waist circumference, men > 90 cm; women> 80 cm) in 76 ESRD patients who had ACS and underwent cardiac catheterization. Results: MS was found in 58 Fersons (76.3%). In the patients with MS, CAD were more prevalent (82% vs 18%, P<0.001) and severe (triple vessels disease, 63.5% vs 0%, P<0.001), compared to those without MS. Multiple logistic regression analysis showed that BMI>24 and low HDL cholesterol were two significant independent predictors of CAD. C onelusions: In ESRD patients complicated with ACS, MS is frequently seen and associated with a high probability of CAD involving multiple vessels. Therefore, detection of MS, especially the components of a high BMI and low HDL cholesterol, is useful for risk stratification in such patients.
P1-13 IMAGE E C G F O R C O R O N A R Y H E A R T D I S E A S E D I A G N O S I S Wen I. Chen 2, Hulhua Kenney CNang 2, Wan Leong Chen ?, Tsorng Liu Hsieh 1, Tung Jing Fang 1. 1Department of Internal Medicine,
Armed Forces Sungs?tan Hospital, Taiwan; 2Institute of Biomedical Engineering, National Yang-Ming University, Taiwan; 3Department of Cardiology, Taipei Veterans General Hospital, Taiwan I n t r o d u c t i o n : Significant Q wave, consistent with previous myocardial infaraction (MI), are highly suggestive of the Desence of significant coronary atherosclerosis. As many as on tNl-d of MIs went unrecognized in the population cohort of the Framingham study. Almost every coronary heart disease (CHD) patient suffers at least one episode of acute coronary syndrome (ACS). Thus, CHD prevalence rate provide and estimate for a maximum incidence of ACS in a given population. Risk stratification in ACS aim at prompt identification of the Ngher risk patient who will profit from aggressive investigation and therapy and if the lower risk patient who can advantageously by treated more conservatively. No clinical or laborato~3J marker is faultless. Method: The image ECG (IECG) can give an integral view especially in temporal evolution and spatial distribution of cardiac signals, and provide not only match to 12qead ECG, but also enhance the efficacy of visual
Olusegun Johnson Ilegbusi. Provost Research Excellence Professor,
University of Central Florida, Orlando, FL32816-2450, USA Cardiovascular disease is the single most coitmlon cause of fatality in the developed world and accounts for ahnost one million deaths annually in the United States alone. It has been es~nated that by the year 2020, cardiovascular disease will claim 25 n~llion deaths worldwide annually and corona~2¢ artery disease (CAD) willrepresent half of these deaths. Although the development of CAD is a complex biologic phenomenon, ~ecent clinical studies demonstrate strong relationsNp between hemodynamics and clinical outcomes such as corona~2¢ deaths, lesion progression and lesion regrowth. These studies underscore the fact that local hemodynamic factors play crucial roles in the development and evolution of coronary obstructions. Due to positive remodeling (outward expansion of arterial wall), vulnerable plaques are often not highly stenotic before rupture. In other words, non obstructive coronary diseases, which are usually undetected by current angiographic techniques, are responsible for most sudden deaths due to myocardial iiffarction (heart attack). There is therefore an urgent need to identify which patients with CAD are likely to have, or to develop, a vulnerable plaque so they may benefit from aggressive intervention before the plaque ruptures. The strategic goal of our research is to develop an integrated ap proach, utilizing the principles of medical imaging, computational fluid dynamics, biomechanics and medicine, to assess the two fundamental pathophysiological mechanisms leading to atherosclerotic plaque ruptm~, namely, plaque composition and local hemodynamics. We have been able to demonstrate the feasibility of an in vivo technique based on ultrasound imaging and biplane coronary angiography, for profiling the human coro nary flow. We have also been able to represent the lumen and plaque size in steady flow situations fairly accurately. This presentation will describe results obtained with this in vivo technique for both native and stented human corona~3J arteries, over a 6 month test period. We will also describe the role of hemodynamics on the location, proliferation, stability and ruptm~ of atherosclerotic plaques.
P1-15 INTRA-AORTIC BALLOON PUMP COUNTERPULSATION- IN THE PERSPECTIVE OF CONTEMPORARY INTERVENTIONAL CARDIOLOGY
Ho Tsun~ Hisn, Ai Hsian Li, Dong Feng Yeih, Chao Lun Lal, Kuo Chin Chen, Yuan Hung Liu, Pen Chih Liao, Yu Wei Chiu, Hsein4ung Lo, Ying Chieh Wang, Chi Yu Yang, Shu Hsun Chu.
Cardiovascular Center, Far-Eastern Memorial Hospital, Taipei County, Taiwan Purpose of the study: The intra aortic balloon pump (IABP) counterpul sation device has been regarded as the last resort to save the acutely411 patients suffering from cardiogenic shock. However, most of the studies of IABP took the stances of cardiovascular surgeons or critical care physi
Abstracts/International Journal of Cardiology 97 Suppt 2 (2004) S 1 ~ 7 5
appreciation by computing and displaying techniques. In this research, we combine the frontal plane and horizontal plane of the traditional 12 lead electric cardiac signals into image format representation. 42 patients, age from 39 to 72, represented with acute corona~2¢ syndi-ome were em-olled in our research. We used the pattern of IECG to identify the symptoms of ACS and compared with other clinical data, history, ECG report and myocardium enzyme, we use the volume integration of the IECG to calculate the Q wave volume and S T T change. Results: By ROC analysis, we calculate the sensitivity and the specificity of frontal plane are 64% and 82%, and horizontal plane are 68% and 86%. The physicians can thus have an overall integral view over a plentiful number of cardiac signals and thereby make diagnosis about the heart conditions of the patient more easily.
apDeciation by computing and displaying techiliques. In tNs ~esearch, we combine the frontal plane and horizontal plane of the traditional 12qead electric cardiac signals into image fomlat representation. 214 patients, age from 35 to 90, represented with coronary heart disease were emolled in our research. We used the pattern of IECG to identify the symptoms of old CHD and compared with other clinical data, history, ECG report and myocardium enzyme, we use the volume integration of the IECG to calculate the ratio of Q wave volume and QR wave volume. Results: By ROC analysis, we calculate the sensitivity and the specificity of frontal plane are 95% and 100%, and horizontal plane are 92.3% and 100%. The physicians can thus have an overall integral view over a plentiful number of cardiac signals and thereby make diagnosis about the heart conditions of the patient more easily.
P1-12 METABOLIC SYNDROME (MS) IS ASSOCIATED WITH M U L T I P L E - V E S S E L S C O R O N A R Y A R T E R Y D I S E A S E (CAD) IN END STAGE RENAL DISEASE (ESRD) PATIENTS C O M P L I C A T E D W I T H A C U T E C O R O N A R Y S Y N D R O M E (ACS)
P1-14 IN-YIVO CHARACTERIZATION OF CARDIOVASCULAR DISEASE
Han Hsiang Chen, Chih Jen Wu, Yi~Chou Chen, Chih Sheng Tsal, Fung J. Lin, Hung I. Yeh. Department of Internal Medicine, Mackay
Memorial Hospital, Taipei, Taiwan Background: People with MS or ESRD are known at increased risk for developing CAD. However, whether in patients with ESRD the Desence of MS adds additional risk for CAD remained unclear. Methods: We retrosFec tively examined the 5 components of M S, includ ing blood pressure (> 130/85 nmffIg), fasting glucose (> 110 mg/dL), fasb ing triglycerides (> 150 mg/dL), high density lipoprotein (HDL) choles terol level (men <40 mg/dL; women <50 mg/dL), and abdominal obesity (waist circumference, men > 90 cm; women> 80 cm) in 76 ESRD patients who had ACS and underwent cardiac catheterization. Results: MS was found in 58 Fersons (76.3%). In the patients with MS, CAD were more prevalent (82% vs 18%, P<0.001) and severe (triple vessels disease, 63.5% vs 0%, P<0.001), compared to those without MS. Multiple logistic regression analysis showed that BMI>24 and low HDL cholesterol were two significant independent predictors of CAD. C onelusions: In ESRD patients complicated with ACS, MS is frequently seen and associated with a high probability of CAD involving multiple vessels. Therefore, detection of MS, especially the components of a high BMI and low HDL cholesterol, is useful for risk stratification in such patients.
P1-13 IMAGE E C G F O R C O R O N A R Y H E A R T D I S E A S E D I A G N O S I S Wen I. Chen 2, Hulhua Kenney CNang 2, Wan Leong Chen ?, Tsorng Liu Hsieh 1, Tung Jing Fang 1. 1Department of Internal Medicine,
Armed Forces Sungs?tan Hospital, Taiwan; 2Institute of Biomedical Engineering, National Yang-Ming University, Taiwan; 3Department of Cardiology, Taipei Veterans General Hospital, Taiwan I n t r o d u c t i o n : Significant Q wave, consistent with previous myocardial infaraction (MI), are highly suggestive of the Desence of significant coronary atherosclerosis. As many as on tNl-d of MIs went unrecognized in the population cohort of the Framingham study. Almost every coronary heart disease (CHD) patient suffers at least one episode of acute coronary syndrome (ACS). Thus, CHD prevalence rate provide and estimate for a maximum incidence of ACS in a given population. Risk stratification in ACS aim at prompt identification of the Ngher risk patient who will profit from aggressive investigation and therapy and if the lower risk patient who can advantageously by treated more conservatively. No clinical or laborato~3J marker is faultless. Method: The image ECG (IECG) can give an integral view especially in temporal evolution and spatial distribution of cardiac signals, and provide not only match to 12qead ECG, but also enhance the efficacy of visual
Olusegun Johnson Ilegbusi. Provost Research Excellence Professor,
University of Central Florida, Orlando, FL32816-2450, USA Cardiovascular disease is the single most coitmlon cause of fatality in the developed world and accounts for ahnost one million deaths annually in the United States alone. It has been es~nated that by the year 2020, cardiovascular disease will claim 25 n~llion deaths worldwide annually and corona~2¢ artery disease (CAD) willrepresent half of these deaths. Although the development of CAD is a complex biologic phenomenon, ~ecent clinical studies demonstrate strong relationsNp between hemodynamics and clinical outcomes such as corona~2¢ deaths, lesion progression and lesion regrowth. These studies underscore the fact that local hemodynamic factors play crucial roles in the development and evolution of coronary obstructions. Due to positive remodeling (outward expansion of arterial wall), vulnerable plaques are often not highly stenotic before rupture. In other words, non obstructive coronary diseases, which are usually undetected by current angiographic techniques, are responsible for most sudden deaths due to myocardial iiffarction (heart attack). There is therefore an urgent need to identify which patients with CAD are likely to have, or to develop, a vulnerable plaque so they may benefit from aggressive intervention before the plaque ruptures. The strategic goal of our research is to develop an integrated ap proach, utilizing the principles of medical imaging, computational fluid dynamics, biomechanics and medicine, to assess the two fundamental pathophysiological mechanisms leading to atherosclerotic plaque ruptm~, namely, plaque composition and local hemodynamics. We have been able to demonstrate the feasibility of an in vivo technique based on ultrasound imaging and biplane coronary angiography, for profiling the human coro nary flow. We have also been able to represent the lumen and plaque size in steady flow situations fairly accurately. This presentation will describe results obtained with this in vivo technique for both native and stented human corona~3J arteries, over a 6 month test period. We will also describe the role of hemodynamics on the location, proliferation, stability and ruptm~ of atherosclerotic plaques.
P1-15 INTRA-AORTIC BALLOON PUMP COUNTERPULSATION- IN THE PERSPECTIVE OF CONTEMPORARY INTERVENTIONAL CARDIOLOGY
Ho Tsun~ Hisn, Ai Hsian Li, Dong Feng Yeih, Chao Lun Lal, Kuo Chin Chen, Yuan Hung Liu, Pen Chih Liao, Yu Wei Chiu, Hsein4ung Lo, Ying Chieh Wang, Chi Yu Yang, Shu Hsun Chu.
Cardiovascular Center, Far-Eastern Memorial Hospital, Taipei County, Taiwan Purpose of the study: The intra aortic balloon pump (IABP) counterpul sation device has been regarded as the last resort to save the acutely411 patients suffering from cardiogenic shock. However, most of the studies of IABP took the stances of cardiovascular surgeons or critical care physi