应用应激心电图分析诊断心脏缺血

A. Amal, G. Reshmi
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引用次数: 5

摘要

心肌缺血是最常见的心脏病。由于在应激状态下心肌缺血状态会占主导地位,因此应激心电图比正常心电图更能有效地用于心肌缺血分析。经临床证实,在进行一系列运动后,发现缺血的几率可高达80%-90%。在心电图中,ST段检测与心肌缺血、心肌梗死密切相关。利用滤波器对应力心电信号进行去噪。利用Pan Tompkins算法找出心电信号的Q、R、S等关键点。其他关键点如P, T, Ton, Toff, J,等电点也可以用窗口法找到。感兴趣的特征是ST段。根据R-R间期计算出心率。通过考虑个体的年龄,将亚最大心率固定,并让患者进行运动应激试验,直到达到亚最大心率为止。在时域和频域对ST段进行了分析。分析次最大心率时和次最大心率后的ST变化趋势。根据临床证实的事实,对于一个缺血的人来说,在放松阶段,ST水平会出现大约两分钟或更长时间的下降。利用MIT-BIH ST变化数据库的信号在MATLAB软件中对算法进行了验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiac Ischemia Diagnosis Using Stress ECG Analysis
Myocardial Ischemia is the most common heart disease. Stress ECG has been effectively used for analysis of the myocardial ischemia than normal ECG because of the reason that ischemic conditions will be dominated in stress conditions. According to the clinically proven facts, after taking a series of exercise, the chance of finding ischemia can rise up to 80%-90%. In ECG, the ST segment detection has close relationship with myocardial ischemia and myocardial infarction. Denoising of the stress ECG has done using filters. The key points of ECG signal like Q, R, S are found out using Pan Tompkins algorithm. Other key points like P, T, Ton, Toff, J, Iso-electric point are also found using window method. The feature of interest is ST segment. Based on R-R interval, heart rate was found out. By considering the age of the individual sub-maximal heart rate is fixed and let the patient to do exercise stress test which lasts until sub-maximal heart rate was reached. The ST segment analysis had been done in time domain as well as in frequency domain. ST trend was analyzed on and after the sub-maximal heart rate. According to the clinically proven facts, for a person having ischemia the ST level shows a depression for about two minutes or more during relaxing stage. The signals from MIT-BIH ST Change Database had been used to verify the algorithm in MATLAB software.
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