Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Ultra-High Resolution Electrocardiography Enables Earlier Detection of Transmural and Subendocardial Myocardial Ischemia Compared to Conventional Electrocardiography

Version 1 : Received: 2 August 2023 / Approved: 3 August 2023 / Online: 3 August 2023 (05:17:42 CEST)

A peer-reviewed article of this Preprint also exists.

Zaichenko, K.V.; Kordyukova, A.A.; Sonin, D.L.; Galagudza, M.M. Ultra-High-Resolution Electrocardiography Enables Earlier Detection of Transmural and Subendocardial Myocardial Ischemia Compared to Conventional Electrocardiography. Diagnostics 2023, 13, 2795. Zaichenko, K.V.; Kordyukova, A.A.; Sonin, D.L.; Galagudza, M.M. Ultra-High-Resolution Electrocardiography Enables Earlier Detection of Transmural and Subendocardial Myocardial Ischemia Compared to Conventional Electrocardiography. Diagnostics 2023, 13, 2795.

Abstract

The sensitivity of exercise ECG is marginally sufficient for detection of mild reduction of coronary blood flow in patients with early coronary atherosclerosis. Here we describe the application of new technique of ECG registration/analysis – ultrahigh resolution ECG (UHR ECG) – for early detection of myocardial ischemia (MIS). The utility of UHR ECG vs. conventional ECG (C ECG) was tested in anesthetized rats and pigs. Transmural MIS was induced in rats by the ligation of the left coronary artery (CA). In pigs, subendocardial ischemia of variable extent was produced by stepwise inflation of balloon within the right CA causing 25-100% reduction of its lumen. In rats, a reduction in power spectral density (PSD) in high-frequency (HF) channel of UHR ECG was registered at 60 s after ischemia (power 0.81±0.14 vs. 1.25±0.12 mW at baseline, p<0.01). This was not accompanied by any ST segment elevation on C ECG. In pigs, PSD in HF channel of UHR ECG was significantly decreased at 25% reduction of CA lumen, while ST segment on C ECG remained unchanged. In conclusion, UHR ECG enabled earlier detection of transmural MIS compared to C ECG. PSD in HF-channel of UHR ECG demonstrated greater sensitivity in the settings of subendocardial ischemia.

Keywords

heart; ischemia; reperfusion; electrocardiography; ultra-high resolution electrocardiography; power spectral density; ischemic heart disease; subclinical atherosclerosis; sensitivity; risk stratification

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

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