MD1080Z - Method for estimating the risk of development of pathological disorders of the myocardium - Google Patents
Method for estimating the risk of development of pathological disorders of the myocardium Download PDFInfo
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- 230000001575 pathological effect Effects 0.000 title claims abstract description 15
- 210000004165 myocardium Anatomy 0.000 title claims abstract description 10
- 238000000034 method Methods 0.000 title claims description 6
- 210000005069 ears Anatomy 0.000 claims abstract description 8
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 claims description 12
- 208000021908 Myocardial disease Diseases 0.000 claims description 2
- 210000000624 ear auricle Anatomy 0.000 abstract description 13
- 239000003814 drug Substances 0.000 abstract description 2
- 230000002107 myocardial effect Effects 0.000 description 11
- 208000035475 disorder Diseases 0.000 description 10
- 230000007170 pathology Effects 0.000 description 10
- 230000000747 cardiac effect Effects 0.000 description 7
- 241000746998 Tragus Species 0.000 description 3
- 238000003745 diagnosis Methods 0.000 description 3
- 238000011282 treatment Methods 0.000 description 3
- 208000024172 Cardiovascular disease Diseases 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 208000019622 heart disease Diseases 0.000 description 2
- 238000005259 measurement Methods 0.000 description 2
- 230000003680 myocardial damage Effects 0.000 description 2
- 206010003658 Atrial Fibrillation Diseases 0.000 description 1
- 208000020446 Cardiac disease Diseases 0.000 description 1
- 238000001467 acupuncture Methods 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 210000004100 adrenal gland Anatomy 0.000 description 1
- 208000037849 arterial hypertension Diseases 0.000 description 1
- 206010003668 atrial tachycardia Diseases 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 210000000748 cardiovascular system Anatomy 0.000 description 1
- 206010012601 diabetes mellitus Diseases 0.000 description 1
- 230000037213 diet Effects 0.000 description 1
- 235000005911 diet Nutrition 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 230000004064 dysfunction Effects 0.000 description 1
- 238000013399 early diagnosis Methods 0.000 description 1
- 238000005755 formation reaction Methods 0.000 description 1
- 210000001932 glossopharyngeal nerve Anatomy 0.000 description 1
- 238000011835 investigation Methods 0.000 description 1
- 239000003550 marker Substances 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 208000031225 myocardial ischemia Diseases 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 230000001272 neurogenic effect Effects 0.000 description 1
- 238000011321 prophylaxis Methods 0.000 description 1
- 238000012216 screening Methods 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 230000006794 tachycardia Effects 0.000 description 1
- 210000003901 trigeminal nerve Anatomy 0.000 description 1
- 210000001186 vagus nerve Anatomy 0.000 description 1
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Abstract
Description
Invenţia se referă la medicină, în special la cardiologie, şi poate fi utilizată pentru aprecierea riscului de apariţie a dereglărilor patologice ale miocardului în perioada preclinică. The invention relates to medicine, in particular to cardiology, and can be used to assess the risk of developing pathological disorders of the myocardium in the preclinical period.
Este cunoscut semnul lui Frank, care este o plică diagonală ce se extinde de la tragus peste lobulul auricular. Semnul este numit după Dr. T. Sanders, Frank. S-a emis ipoteza că semnul Frank este un indicator al bolilor cardiovasculare şi/sau diabetului zaharat. Unele studii au descris semnul Frank ca un marker al bolilor cardiovasculare, dar fără a indica gravitatea afecţiunii [1]. Frank's sign is known, which is a diagonal fold extending from the tragus over the earlobe. The sign is named after Dr. T. Sanders, Frank. It has been hypothesized that Frank's sign is an indicator of cardiovascular disease and/or diabetes mellitus. Some studies have described Frank's sign as a marker of cardiovascular disease, but without indicating the severity of the condition [1].
Sistemul existent de ambulatoriu şi de examinare cardiologică a bolnavilor, în multe cazuri, nu oferă posibilitatea de a evidenţia dereglările miocardului la etapa subclinică. Din această cauză se şi manifestă pe neaşteptate unele patologii cardiace la persoanele, care au fost considerate sănătoase. O modalitate de a preveni afecţiunile cardiace este utilizarea unor tehnologii precise de screening ECG pentru identificarea rapidă şi precisă a persoanelor cu risc crescut de dereglări patologice ale miocardului în perioada subclinică. Astfel de tehnologii asigură o monitorizare detaliată şi frecventă a dinamicii cordului, care permite identificarea la timp a simptomelor bolii la etapa prespitalicească. Dispozitivul Cardiovisor-06C este destinat pentru determinarea microalternaţiilor electrice ale semnalelor ECG. Dispozitivele de măsurare a microalternaţiilor nu sunt destinate pentru a diagnostica tipul de patologie, dar pentru a determina riscul de apariţie a dereglărilor patologice. Măsurările se efectuează cu ajutorul a 4 electrozi conectaţi la toate membrele. Dispozitivul include un sistem computerizat de determinare a zonelor afectate ale miocardului cu determinarea indicelui miocardic, care în normă este de 0…15%, iar 15…17% se consideră o stare intermediară între sănătos şi apariţia de schimbări în ţesutul miocardului [2]. The existing system of outpatient and cardiological examination of patients, in many cases, does not provide the opportunity to highlight myocardial disorders at the subclinical stage. For this reason, some cardiac pathologies are unexpectedly manifested in people who were considered healthy. One way to prevent heart diseases is to use precise ECG screening technologies for rapid and accurate identification of people with an increased risk of myocardial pathological disorders in the subclinical period. Such technologies provide detailed and frequent monitoring of heart dynamics, which allows for timely identification of symptoms of the disease at the prehospital stage. The Cardiovisor-06C device is designed to determine electrical microalternations of ECG signals. Microalternation measurement devices are not designed to diagnose the type of pathology, but to determine the risk of pathological disorders. Measurements are performed using 4 electrodes connected to all limbs. The device includes a computerized system for determining the affected areas of the myocardium with the determination of the myocardial index, which is normally 0…15%, and 15…17% is considered an intermediate state between healthy and the occurrence of changes in myocardial tissue [2].
Dezavantajele metodei cunoscute constau în necesitatea unor dispozitive computerizate costisitoare, precum şi a unui personal şcolarizat pentru utilizarea lor, ceea ce este imposibil în condiţii de ambulatoriu de a stabili riscul de dezvoltare a patologiilor cardiace. The disadvantages of the known method consist in the need for expensive computerized devices, as well as trained personnel for their use, which makes it impossible in outpatient conditions to establish the risk of developing cardiac pathologies.
Problema pe care o rezolvă invenţia constă în elaborarea unei metode de apreciere a riscului de apariţie a dereglărilor patologice ale miocardului cu posibilitatea de utilizare în condiţii de ambulatoriu, rurale, fără necesitatea unor dispozitive computerizate costisitoare, cu stabilirea unui grad al riscului de afectare a miocardului şi diagnosticarea timpurie a stărilor patologice cardiace, în scop de profilaxie a progresării unor patologii ale miocardului. The problem solved by the invention consists in developing a method for assessing the risk of developing pathological disorders of the myocardium with the possibility of use in outpatient, rural conditions, without the need for expensive computerized devices, with the establishment of a degree of risk of myocardial damage and early diagnosis of cardiac pathological conditions, for the purpose of prophylaxis of the progression of myocardial pathologies.
Esenţa invenţiei constă în aceea că cu ajutorul unui şubler se măsoară lungimea transversală a lobulilor auriculari şi lungimea plicilor transversale de pe lobulii auriculari ai ambelor urechi, cu determinarea următoarelor variaţii şi atribuirea unor valori: lipsa plicii transversale a lobulului auricular stâng - 0, a lobulului auricular drept - 0; lungimea plicii transversale este de până la 50% din lungimea transversală a lobulului auricular stâng - 1, a lobulului auricular drept - 1; lungimea plicii transversale este mai mare de 50%, dar mai mică de 100% din lungimea transversală a lobulului auricular stâng - 2, a lobulului auricular drept - 2; lungimea plicii transversale este egală cu lungimea transversală a lobulului auricular stâng - 3, a lobulului auricular drept - 3; plica transversală a lobulului auricular stâng conţine mai mult de o linie - 4, a lobulului auricular drept - 4. În cazul în care se determină suma valorilor pentru ambele urechi de 0…5, se apreciază un risc minim, de 6…15 - un risc mediu şi de 16…20 se apreciază un risc major de apariţie a dereglărilor patologice ale miocardului. The essence of the invention consists in measuring the transverse length of the auricular lobes and the length of the transverse folds on the auricular lobes of both ears with the help of a caliper, determining the following variations and assigning values: absence of the transverse fold of the left auricular lobe - 0, of the right auricular lobe - 0; the length of the transverse fold is up to 50% of the transverse length of the left auricular lobe - 1, of the right auricular lobe - 1; the length of the transverse fold is greater than 50%, but less than 100% of the transverse length of the left auricular lobe - 2, of the right auricular lobe - 2; the length of the transverse fold is equal to the transverse length of the left auricular lobe - 3, of the right auricular lobe - 3; the transverse fold of the left auricular lobe contains more than one line - 4, of the right auricular lobe - 4. If the sum of the values for both ears is determined to be 0…5, a minimal risk is assessed, 6…15 - a medium risk and 16…20 a major risk of developing pathological disorders of the myocardium is assessed.
Rezultatul invenţiei constă în simplificarea metodei de determinare a riscului de apariţie a dereglărilor patologiilor cardiace, uşor de utilizat în condiţii de ambulatoriu şi în alte instituţii prespitaliceşti, rurale, fără necesitatea unor dispozitive computerizate costisitoare, cu stabilirea unui grad al riscului de afectare a miocardului pentru determinarea necesităţii unui diagnostic cardiologic şi tratamentului timpuriu, dacă este necesar, cu scop de profilaxie a progresării unor patologii ale miocardului. The result of the invention consists in simplifying the method for determining the risk of cardiac pathology disorders, easy to use in outpatient settings and in other pre-hospital, rural institutions, without the need for expensive computerized devices, with the establishment of a degree of risk of myocardial damage to determine the need for a cardiological diagnosis and early treatment, if necessary, with the aim of preventing the progression of myocardial pathologies.
Este cunoscut faptul că la pacienţii cardiaci se determină clinic o durere, care radiază spre gât, bărbie şi zona occipitală, ce se datorează prezenţei unor ramuri nervoase, având o legătură directă. S-a demonstrat existenţa legăturilor neurogene reflexogene între cord şi zonele auriculare, care se realizează prin intermediul nervilor trigemen, glosofaringian şi vag (Дуринян Р. Физиологические основы аурикулярной рефлексотерапии. Ереван, 1983). Au fost studiate unele aspecte ale unor formaţiuni de pe lobulul auricular, şi anume prezenţa unor plici transversale de diferită lungime, care indică la prezenţa unor dereglări cardiace, ce pot fi şi la oameni practic sănătoşi, dar prezintă un indiciu de risc de apariţie a unei patologii acute cardiace. Sunt importante două aspecte topografice diferite, care trebuie luate în considerare: primul este faptul că punctul de plecare al plicii transversale, chiar sub canelura intertragus, este constant pentru toate tipurile de plici. Al doilea este unghiul variabil al plicilor, care traversează lobulul urechii cuprinzând, prin urmare, o suprafaţă diferită a părţii anterioare a lobulului. Posibilitatea că această zonă auriculară este legată de disfuncţii ale sistemului cardiovascular poate fi susţinută de faptul că doar în apropiere pe tragus există puncte reflexogene legate de inimă, cum ar fi xinzangdian, situate în zona TG1, cu indicaţii de fibrilaţie atrială şi tahicardie. Alte puncte pentru tratarea hipertensiunii arteriale sunt localizate în zona TG2 şi a glandei suprarenale shensJwig-xian, care este situat la marginea liberă a tragus între TG1 şi TG2 (Marco Romoli, Pierre Rabischong, Filadelfio Puglisi. Auricular acupuncture diagnosis. 2010, p. 76-78). It is known that in cardiac patients, a pain is clinically determined, radiating to the neck, chin and occipital area, which is due to the presence of nerve branches, having a direct connection. The existence of neurogenic reflexogenic connections between the heart and the auricular areas, which are achieved through the trigeminal, glossopharyngeal and vagus nerves, has been demonstrated (Дуринян R. Физиологические основы аурикулярной рефлексотерапии. Ереван, 1983). Some aspects of some formations on the auricular lobule have been studied, namely the presence of transverse folds of different lengths, which indicate the presence of cardiac disorders, which can also be in practically healthy people, but present an indication of the risk of developing an acute cardiac pathology. Two different topographic aspects are important, which must be taken into account: the first is the fact that the starting point of the transverse fold, just below the intertragus groove, is constant for all types of folds. The second is the variable angle of the folds, which cross the earlobe, thus covering a different surface area of the anterior part of the lobule. The possibility that this auricular area is related to cardiovascular system dysfunctions can be supported by the fact that only nearby on the tragus are there reflexogenic points related to the heart, such as xinzangdian, located in the TG1 area, with indications for atrial fibrillation and tachycardia. Other points for treating arterial hypertension are located in the TG2 area and the adrenal gland shensJwig-xian, which is located at the free edge of the tragus between TG1 and TG2 (Marco Romoli, Pierre Rabischong, Filadelfio Puglisi. Auricular acupuncture diagnosis. 2010, p. 76-78).
Metoda se efectuează în felul următor. The method is performed as follows.
Cu ajutorul unui şubler se măsoară lungimea proiecţiei unei linii transversale a lobulului auricular şi lungimea plicii transversale de pe lobulul auricular la ambele urechi, cu determinarea unor variaţii, cărora li se atribuie următoarele puncte (v. tab.): lipsa plicii transversale a lobulului auricular stâng - 0, a lobulului auricular drept - 0; lungimea plicii transversale este de până la 50% din lungimea transversală a lobulului auricular stâng - 1, a lobulului auricular drept - 1; lungimea plicii transversale este mai mare de 50%, dar mai mică de 100% din lungimea transversală a lobulului auricular stâng - 2, a lobulului auricular drept - 2; lungimea plicii transversale este egală cu lungimea transversală a lobulului auricular stâng - 3, a lobulului auricular drept - 3; plica transversală a lobulului auricular stâng conţine mai mult de o linie - 4, a lobulului auricular drept - 4. În cazul în care se determină suma valorilor pentru ambele urechi de 0…5, se apreciază un risc minim, de 6…15 - un risc mediu şi de 16…20 se apreciază un risc major de apariţie a dereglărilor patologice ale miocardului. Using a caliper, the length of the projection of a transverse line of the auricular lobe and the length of the transverse fold on the auricular lobe in both ears are measured, with the determination of some variations, which are assigned the following points (see table): lack of transverse fold of the left auricular lobe - 0, of the right auricular lobe - 0; the length of the transverse fold is up to 50% of the transverse length of the left auricular lobe - 1, of the right auricular lobe - 1; the length of the transverse fold is greater than 50%, but less than 100% of the transverse length of the left auricular lobe - 2, of the right auricular lobe - 2; the length of the transverse fold is equal to the transverse length of the left auricular lobe - 3, of the right auricular lobe - 3; the transverse fold of the left auricular lobe contains more than one line - 4, of the right auricular lobe - 4. If the sum of the values for both ears is determined to be 0…5, a minimal risk is assessed, 6…15 - a medium risk and 16…20 a major risk of developing pathological disorders of the myocardium is assessed.
Tabel Table
Nr. d/o Criterii Punctaj de apreciere a pe lobulul auricular plicii transversale Lobulul auricular drept Lobulul auricular stâng 1 Lipsa plicii transversale a lobulului auricular 0 0 2 Lungimea plicii transversale a lobulului auricular este de până la 50% din lungimea transversală a lobulului auricular 1 1 3 Lungimea plicii transversale este de la 50%, dar mai mică de 100% din lungimea transversală a lobulului auricular 2 2 4 Lungimea plicii transversale este de 100% din lungimea transversală a lobulului auricular 3 3 5 Plica transversală a lobulului auricular conţine mai mult de o linie 4 4 Total 0…20 puncte No. d/o Criteria Assessment score of the transverse fold on the auricular lobule Right auricular lobule Left auricular lobule 1 Lack of transverse fold of the auricular lobule 0 0 2 The length of the transverse fold of the auricular lobule is up to 50% of the transverse length of the auricular lobule 1 1 3 The length of the transverse fold is from 50%, but less than 100% of the transverse length of the auricular lobule 2 2 4 The length of the transverse fold is 100% of the transverse length of the auricular lobule 3 3 5 The transverse fold of the auricular lobule contains more than one line 4 4 Total 0…20 points
După stabilirea numărului de puncte pentru toate persoanele, care au fost incluse în studiu, în număr de 180, dintre care au fost şi persoane sănătoase, şi persoane cu patologii ale miocardului, datele obţinute conform invenţiei revendicate au fost confirmate cu ajutorul Cardiovizorului 06C pentru determinarea gradului de ischemie a miocardului şi stabilirea indicelui miocardic (IM), care în normă este de 0…15%, şi anume pentru persoanele cu astfel de indice nu s-a depistat prezenţa plicilor transversale pe lobulii auriculari. La persoanele cu suma de 1…5 puncte s-a determinat IM de 16…20%, s-a stabilit un risc minor de apariţie a dereglărilor patologice ale miocardului, persoanelor în cauză li se recomandă de a corija dieta şi controlul indicilor biochimici ai sângelui o dată pe an; în cazul sumei de 6…15 puncte s-a determinat IM de 20…30%, s-a stabilit un risc mediu de apariţie a dereglărilor patologice ale miocardului, persoanelor în cauză li se recomandă consultaţia medicului cardiolog pentru investigaţii paraclinice în vederea stabilirii diagnosticului şi indicarea tratamentului, dacă este necesar, şi în cazul sumei de 16…20 de puncte s-a determinat IM de 31…58%, s-a stabilit un risc major de apariţie a dereglărilor patologice ale miocardului, iar persoanelor în cauză li se recomandă consultaţia medicului cardiolog cu spitalizarea lor de urgenţă în vederea tratamentului patologiei cardiace. În cazul când indicele miocardic este mai mare de 58%, la pacienţi este prezent tabloul clinic de patologie a miocardului. After determining the number of points for all persons included in the study, 180 of whom were both healthy and persons with myocardial pathologies, the data obtained according to the claimed invention were confirmed using the Cardiovisor 06C to determine the degree of myocardial ischemia and establish the myocardial index (MI), which is normally 0…15%, namely for persons with such an index the presence of transverse folds on the auricular lobules was not detected. In persons with the sum of 1…5 points, MI of 16…20% was determined, a minor risk of pathological disorders of the myocardium was established, the persons in question are recommended to correct their diet and control biochemical blood indices once a year; in the case of a sum of 6…15 points, MI of 20…30% was determined, an average risk of myocardial pathological disorders was established, the persons in question are recommended to consult a cardiologist for paraclinical investigations in order to establish the diagnosis and indicate treatment, if necessary, and in the case of a sum of 16…20 points, MI of 31…58% was determined, a major risk of myocardial pathological disorders was established, and the persons in question are recommended to consult a cardiologist with their emergency hospitalization for the treatment of cardiac pathology. In the case when the myocardial index is higher than 58%, the clinical picture of myocardial pathology is present in the patients.
Exemplul 1 Example 1
Persoana A., 30 ani, din grupul care a participat la studiu, conform metodei revendicate s-a stabilit prezenţa a 4 puncte, fapt ce a fost confirmat cu ajutorul Cardiovizorului 06C cu indicele miocardic de 18%, deci s-a stabilit un risc minor de apariţie a dereglărilor patologice ale miocardului. Person A., 30 years old, from the group that participated in the study, according to the claimed method, the presence of 4 points was established, which was confirmed with the help of the Cardiovisor 06C with a myocardial index of 18%, so a minor risk of the occurrence of pathological disorders of the myocardium was established.
Exemplul 2 Example 2
Persoana C., 42 ani, din grupul care a participat la studiu, conform metodei revendicate s-a stabilit prezenţa a 12 puncte, fapt ce a fost confirmat cu ajutorul Cardiovizorului 06C cu indicele miocardic de 30%, deci s-a stabilit un risc mediu de apariţie a dereglărilor patologice ale miocardului. Person C., 42 years old, from the group that participated in the study, according to the claimed method, the presence of 12 points was established, which was confirmed with the help of the Cardiovisor 06C with a myocardial index of 30%, so an average risk of developing pathological disorders of the myocardium was established.
Exemplul 3 Example 3
Persoana V., 62 ani, din grupul care a participat la studiu, conform metodei revendicate s-a stabilit prezenţa a 20 puncte, fapt ce a fost confirmat cu ajutorul Cardiovizorului 06C cu indicele miocardic de 58%, deci s-a stabilit un risc major de apariţie a dereglărilor patologice ale miocardului. Person V., 62 years old, from the group that participated in the study, according to the claimed method, the presence of 20 points was established, which was confirmed with the help of the Cardiovisor 06C with a myocardial index of 58%, so a major risk of developing pathological disorders of the myocardium was established.
1. Frank's sign. Wikipedia. 31 August 2015. https://en.wikipedia.org/wiki/Frank%27s_sign 1. Frank's sign. Wikipedia. 31 Aug. 2015. https://en.wikipedia.org/wiki/Frank%27s_sign
2. Иванов Г., Сула А. Дисперсионное ЭКГ картирование: теоретические основы и клиническая практика , Москва, Техносфера, 2009, p. 9-30 2. Ivanov G., Sula A. Дисперсионное ЕКГ картирование: theoretical foundations and clinical practice, Moscow, Техносфера, 2009, p. 9-30
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Non-Patent Citations (5)
| Title |
|---|
| 1. Иванов Г., Сула А. Дисперсионное ЭКГ картирование: теоретические основы и клиническая практика , Москва, Техносфера, 2009, p. 9-30 * |
| Frank's sign. Wikipedia. 31 August 2015. https://en.wikipedia.org/wiki/Frank%27s_sign * |
| George Griffing, M.D.Frank's Sign.The new England J. of Medicine. 2014, nr. 370 * |
| Mustafa Ahmed. Earlobe Crease and Heart Disease - Fact Or Myth? A Brief History: Frank’s Sign. August 13, 2014, Găsit: http://myheart.net/articles/earlobe-crease-and-heart-disease-fact-or-myth/ * |
| Risheng Xu, John Pham. Frank's sign: a coronary artery disease predictor. 15 July 2014, BMJ Case Reports 2014; doi:10. 1136/bcr-2014-205770 * |
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|---|---|---|---|
| FG9Y | Short term patent issued | ||
| KA4Y | Short-term patent lapsed due to non-payment of fees (with right of restoration) | ||
| MM4A | Patent for invention definitely lapsed due to non-payment of fees |