WO2002000108A2 - Procede pour la determination d'un parametre applicable au diagnostic a partir de donnees electrocardiographiques et magnetocardiographiques d'un patient - Google Patents

Procede pour la determination d'un parametre applicable au diagnostic a partir de donnees electrocardiographiques et magnetocardiographiques d'un patient Download PDF

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Publication number
WO2002000108A2
WO2002000108A2 PCT/EP2001/006649 EP0106649W WO0200108A2 WO 2002000108 A2 WO2002000108 A2 WO 2002000108A2 EP 0106649 W EP0106649 W EP 0106649W WO 0200108 A2 WO0200108 A2 WO 0200108A2
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WO
WIPO (PCT)
Prior art keywords
vector
data
ecd
patient
angle
Prior art date
Application number
PCT/EP2001/006649
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German (de)
English (en)
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WO2002000108A3 (fr
Inventor
Fritz Steinberg
Mykola Budnyk
Volodymyr Sosnitzky
Original Assignee
Squid International Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Squid International Ag filed Critical Squid International Ag
Priority to EP01969304A priority Critical patent/EP1337181A2/fr
Priority to AU2001289601A priority patent/AU2001289601A1/en
Publication of WO2002000108A2 publication Critical patent/WO2002000108A2/fr
Publication of WO2002000108A3 publication Critical patent/WO2002000108A3/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/242—Detecting biomagnetic fields, e.g. magnetic fields produced by bioelectric currents
    • A61B5/243—Detecting biomagnetic fields, e.g. magnetic fields produced by bioelectric currents specially adapted for magnetocardiographic [MCG] signals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/339—Displays specially adapted therefor
    • A61B5/341—Vectorcardiography [VCG]

Definitions

  • the invention relates to a method for determining a diagnostically relevant parameter from electrocardiographic and magnetocardiographic data of a patient.
  • the application relates to a method by means of which a diagnostically relevant parameter can be determined, which is suitable as a measure for the deviation of the myocardial conductivity of the examined patient from the normal state and which makes it possible to identify heart diseases which are associated with conductivity disorders.
  • ECG electrocardiography
  • EMF electromotive force
  • HV electrical heart vector
  • the first evidence of the heart's magnetic field i.e. on
  • Magnetocardiogram was reported in 1963 (see Baule G. McFee R., Detection of the Magnetic Field of the Heart. - Am. Heart J. - 55. - 1963 - p. 95 - 98).
  • MCG Magnetocardiogram
  • the MCG process uses an equivalent magnetic dipole, which is also magnetic
  • MCG Cardiac vector
  • ECD equivalent current dipole
  • MCG and ECG are not completely independent.
  • the MCG has a complementary nature to the ECG, since the MCG is only sensitive to the tangential components of the ECD.
  • the ECG is sensitive to both the radial and the tangential ECD components, and the latter component is delayed by a large electrical resistance of the surrounding lung tissue (Stroink G., Moshade W., Achenbach S .: Cardiomagnetism. In: Magnetism in Medicine - Andra W., Nowak H., Eds.- Berlin: Wiley VCH - 1998, p. 136 - 189).
  • the myocardium is known to have many types of anisotropy.
  • the first reason is the difference between the transverse and longitudinal conductivity of the heart cell.
  • anisotropy is caused by the spiral nature of the heart muscle fibers. These types of anisotropy change from one normal subject to another. However, many types of anisotropy are determined by an anisotropy of conductivity.
  • the conductivity anisotropy changes in healthy people, but also changes to a sufficient extent due to cardiac disorders.
  • the aim of the ECG and MCG methods is to solve the so-called "inverse problem" (see, for example, B. Hailer et al .: The application of biomagnetism in cardiology. In: Praktician Kardiologie, Vol. 15, 1995 , Pp. 90 - 103, the content of which is hereby incorporated into the revelation by quoting).
  • inverse problem see, for example, B. Hailer et al .: The application of biomagnetism in cardiology. In: Praktician Kardiologie, Vol. 15, 1995 , Pp. 90 - 103, the content of which is hereby incorporated into the revelation by quoting.
  • Realistic forms of each patient are usually obtained from magnetic resonance image data and numerically determined using the boundary element method.
  • the procedures are complex and time consuming and the exact conductivity is unknown.
  • the cardiac generator is the sum of the equivalent current generators (dipole, quadrupole, octupol etc., where ECD is the equivalent generator of the lowest order).
  • EMD equivalent magnetic dipole
  • the current generators mentioned in the previous paragraph reflect the "flow" currents, i.e. the currents which have thresholds and sinks. Closed or eddy currents are modeled by an equivalent magnetic multipole.
  • the named EMD is the equivalent lowest order magnetic generator.
  • the fundamental difference between ECG and MCG is that the former is insensitive to eddy currents, i.e. magnetic generators. It was shown that the ECG did not change after the stress test (the heart rate increased from 60 to 140 beats per minute) for the repolarization phase. In contrast, that shows MCG changes dramatically and the EMD changes its own value and direction.
  • EMD is very sensitive to non-pathological changes in the human heart. This is the reason why it cannot be used to demonstrate myocardial conductivity, particularly the anisotropy caused by heart disease.
  • heart indices diagnostically meaningful parameters that allow the determination of anisotropies of the myocardial conductivity. This is the reason why the problem of developing a new method that has good sensitivity and specificity with regard to the various heart diseases accompanied by anisotropy changes is very topical today.
  • the present invention fulfills the need for such a method and has corresponding advantages.
  • a new method for determining the anisotropy of myocardial conductivity takes into account that the ECG cannot recognize the myocardial anisotropy - that the MCG is affected by the myocardial anisotropy, that the angle between ECG and MCG data is due to of
  • Heart disease varies that the combination of ECG and MCG the sensitivity of both procedures in the
  • the ECD vector is used as a model for the MCG and the EMF vector is used to interpret the ECG data.
  • the combination of ECG and MCG should increase the sensitivity of the method mentioned.
  • the present invention is devoted to developing a new method that has a number of advantages compared to conventional patterns.
  • the proposed method distinguishes the group of normal subjects and the group of patients with coronary artery disease (CAD). This result allows the CAD patient identification procedure to be used.
  • CAD coronary artery disease
  • the present invention provides a new method of processing human heart data obtained during clinical studies
  • the degree of anisotropy is characterized by an angle ⁇ between the direction ( ⁇ ) of a vector of the electromotive force (EMF) and the direction ( ⁇ ) of a simultaneous electrical current dipole vector (ECD) in the heart.
  • EMF electromotive force
  • ECD simultaneous electrical current dipole vector
  • the electrocardiographic (ECG) data are combined with the magnetocardiographic (MCG) data.
  • the method for obtaining an anisotropy angle is based on the following
  • a time sequence of the measured MCG signal of the human heart is measured.
  • the magnetic signal is then filtered and also averaged.
  • a time sequence of the two-dimensional magnetic field distribution maps is then formed (so-called magnetic field mapping - see, for example, the explanations in Wilfried Andrä, Hannes Nowak (ed.): Magnetism in Medicine. Berlin: WILEY-VCH, 1998, the content of which is hereby fully understood Quotation is used for revelation).
  • the direction of the ECD vector at each point in time is determined using the method of magnetic Moments based solution of the inverse problem is calculated.
  • the presented method according to the invention is intended for the medical diagnosis of heart diseases.
  • the method is intended to diagnose such heart diseases associated with various myocardial disorders
  • the present invention provides a new method for identifying coronary artery disease (CAD) by detecting the following steps. First the R-tip and the T-tip of the cardio cycle are selected. Second, the anisotropy angles are determined at selected locations for CAD patients. Thirdly, the angles mentioned are compared with those of normal subjects at the same peaks.
  • CAD coronary artery disease
  • the first step is to determine the EMF vector direction in the R and T peaks.
  • the second step is to determine the ECD vector direction in the same peaks.
  • the third step is to obtain the anisotropy angle in the selected peaks by subtracting the direction of the ECD vector from that of the EMF vector.
  • An important aspect of the invention is that the method is intended to process data measured by the single-channel magnetocardiograph installed in medical clinics and the vector electrocardiograph.
  • the proposed method is aimed at diagnostic To use apparatus placed in an unshielded environment in the urban area.
  • FIG. 1 shows the mean ⁇ standard deviation values (SE) of the anisotropy angle ⁇ in the R peak; and
  • FIG. 2 shows the mean ⁇ SE values of the anisotropy angle ⁇ in the T-tip.
  • SE standard deviation values
  • CAD CAD
  • NVM normal subjects
  • the vector ECG (company, model) and the standard method for determining the direction of the EMF vector in the frontal plane in the R and T tips are used (see, for example - .. the information on the above procedure).
  • the single-channel magnetocardiograph (model MCG-1, manufacturer SQUID AG, Essen, Germany) is used to measure the magnetic heart signal in a non-shielded environment in medical clinics. The device mentioned allows
  • the signals are continuously sampled at a discretization frequency of 500 Hz for a period of 30 seconds.
  • a software was developed to process the signals, which allows the scanning, filtering, artifact removal and averaging (for details see European patent - ... our patent).
  • the software allows the reconstruction of magnetic field distribution maps and the determination of the ECD vector based on the solution of the inverse problem (Romanovich S., Sosnitsky V., Voytovich I .: Investigation of Biomagnetic Field Using 2D Model of Secondary Sources // Proc. 9 Int Conf.Biomagnetism, Vienna (Austria) - 1996. - p. 455 - 456).
  • one method of demonstrating myocardial conductivity presented is based on the finding that the degree of manifestation of myocardial anisotropy is indicated by an angle ⁇ between a direction ( ⁇ ) of an EMF vector and the direction ( ⁇ ) of a simultaneous ECD
  • the time sequences of the measured ECG and MCG signals from the human heart were measured. These time sequences were filtered and averaged to improve the signal-to-noise ratio. Then the directions of the EMF and ECD vectors were calculated.
  • the anisotropy angle ⁇ in the R peak is in a range of 20.8 ° ⁇ 3.3 ° (mean ⁇ standard error (SE)) for healthy volunteers and is within a range of 61.7 ° + 17.2 ° for CAD patients.
  • Figure 2 shows that during the T-wave the angle is in the range of 18 ° + 5.3 ° for healthy people and in the range of 45.5 ° + 13.5 ° for CAD patients.
  • SE mean ⁇ standard error
  • angle ⁇ of anatomical peculiarities of the human heart depends on one person to another. It also varies due to myocardial disorders
  • the essential feature involves the use of a
  • ECG or MCG data do not in principle give the quantity of information that is necessary to determine the degree of anisotropy in the human heart. Only ECG data combined with MCG data can solve the problem of anisotropy in myocardial conductivity. The reason for this is that the ECG and the MCG provide mutually complementary information about the electrical heart generator. This is the reason why the summarized data of the electric and magnetic fields generated by the human heart give the complete information about the electrophysiological process in the myocardium.
  • the most important advantageous result of the present invention is that the preferred approach can potentially be used to identify CAD. It is confirmed by the high level of specificity and sensitivity. In the present embodiment, the specificity and sensitivity are 85% and 93%, respectively. The results of the particular embodiment indicate that the angle of the
  • Anisotropy in CAD patients increases compared to healthy volunteers.
  • the increase mentioned is greater for the R peak (approximately three times) than for the T wave (approximately twice).
  • the increase in CAD is explained by the decrease in the axial component of the myocardial conductivity due to the existence of ischemic zones with lower conductivity.
  • Another advantage of the approach presented is that it can be used in simple medical (cardiological) clinics that are only simple
  • the ECG equipment must include a vector ECG apparatus with the standard software for determining the direction of the EMF vector.
  • the above-mentioned MCG technique must include the least expensive one-channel magnetocardiograph that operates in the unshielded environment at the high level of urban magnetic interference and appropriate software that allows the direction of the ECD vector to be determined.
  • the particular embodiment shows the possibility of using the anisotropy angle as a diagnostic criterion for identifying the CAD.
  • the invention is not so limited.
  • the processing procedure for determining the degree of anisotropy can be complicated.
  • the calculation of the anisotropy angle can be carried out for every point in the cardio cycle.
  • the heart disease to be diagnosed can be other than CAD.
  • the necessary condition is essentially that the disease mentioned should have disorders of myocardial conductivity, which lead to a change in the degree of anisotropy.
  • the magnetocardiograph consists of low-temperature superconductors and is close to the absolute zero in liquid Helium works, the invention is not limited to this.
  • the magnetocardiograph can be a high temperature magnetocardiograph and operated near or above 77 ° K.
  • the magnetocardiograph can be a multi-channel magnetocardiograph with suppression of environmental noise, and can be located in a magnetic and / or radio frequency chamber.
  • the magnetocardiograph need not necessarily be superconducting, but rather can work on the basis of some principles.
  • the essential necessary condition is that the magnetocardiograph allows the measurement of the magnetic field in a grid that is placed in the frontal plane above the heart.
  • the method according to the invention makes it possible to create a working basis for the diagnostic activity of the doctor or

Abstract

L'invention concerne un procédé selon lequel le sens du vecteur de force électromotrice (vecteur FEM) du coeur est calculé à partir de données électrocardiographiques à au moins un instant sélectionné du cycle cardiaque et le sens du vecteur de dipôle de courant électrique (vecteur DCE) du coeur est calculé à partir de données magnétocardiographiques au moins au même instant sélectionné du cycle cardiaque. L'angle entre le sens du vecteur FEM et celui du vecteur DCE à l'instant sélectionné du cycle cardiaque est alors calculé : il représente une mesure pour l'anisotropie myocardique du coeur du patient examiné. Il a été démontré que, chez des patients souffrant de coronaropathie, l'angle calculé se situe dans une zone angulaire totalement différente de celle des personnes en bonne santé.
PCT/EP2001/006649 2000-06-12 2001-06-12 Procede pour la determination d'un parametre applicable au diagnostic a partir de donnees electrocardiographiques et magnetocardiographiques d'un patient WO2002000108A2 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP01969304A EP1337181A2 (fr) 2000-06-12 2001-06-12 Procede pour la determination d'un parametre applicable au diagnostic a partir de donnees electrocardiographiques et magnetocardiographiques d'un patient
AU2001289601A AU2001289601A1 (en) 2000-06-12 2001-06-12 Method for determining a diagnostically relevant parameter from the electrocardiographical and magnetocardiographical data of a patient

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE10028254 2000-06-12
DE10028254.7 2000-06-12

Publications (2)

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WO2002000108A2 true WO2002000108A2 (fr) 2002-01-03
WO2002000108A3 WO2002000108A3 (fr) 2003-05-30

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EP (1) EP1337181A2 (fr)
AU (1) AU2001289601A1 (fr)
DE (1) DE10128293A1 (fr)
WO (1) WO2002000108A2 (fr)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19808985A1 (de) * 1997-03-07 1998-09-10 Hitachi Ltd Verfahren und Vorrichtung zur Biomagnetfeld-Messung
WO2001020477A2 (fr) * 1999-08-28 2001-03-22 Squid Ag Procede informatise de traitement automatique de donnees de champs biomagnetiques, en particulier de donnees magnetocardiographiques

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19808985A1 (de) * 1997-03-07 1998-09-10 Hitachi Ltd Verfahren und Vorrichtung zur Biomagnetfeld-Messung
WO2001020477A2 (fr) * 1999-08-28 2001-03-22 Squid Ag Procede informatise de traitement automatique de donnees de champs biomagnetiques, en particulier de donnees magnetocardiographiques

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
TSUKADA K ET AL: "Noninvasive visualization of activated regions and current flow in the heart by analyzing vector components of a cardiac magnetic field" COMPUTERS IN CARDIOLOGY, 1999 HANNOVER, GERMANY 26-29 SEPT. 1999, PISCATAWAY, NJ, USA,IEEE, US, 26. September 1999 (1999-09-26), Seiten 403-406, XP010367105 ISBN: 0-7803-5614-4 *

Also Published As

Publication number Publication date
DE10128293A1 (de) 2002-06-06
AU2001289601A1 (en) 2002-01-08
EP1337181A2 (fr) 2003-08-27
WO2002000108A3 (fr) 2003-05-30

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