Comparative study of local and Karhunen-Loève-based ST-T indexes in recordings from human subjects with induced myocardial ischemia.


Journal Article

In this work we studied ST-T complex changes in the ECG as result of induced ischemia. The principal aim was to determine whether global changes in the ST-T complex were more sensitive markers of ischemic alterations than those based on measurements of changes at specific locations on ST segment or T wave. High-resolution ECGs from patients undergoing percutaneous transluminal coronary angioplasty in one of the major coronary arteries were analyzed to give a description of the period from the end of active depolarization (QRS complex) to the end of active repolarization (T wave). During artery occlusion traditional local measurements of the ST-T complex were compared to global measurements based on the Karhunen-Loève transform. An ischemic change sensor parameter was estimated for each of the studied indexes showing that global measurements detected changes better in the repolarization period in a larger number of leads and with higher sensitivity (more than 85%) than was done using local measurements (sensitivity of 64% with ST level, 33% with T-wave maximum position, and 37% with T-wave maximum amplitude). Using these global indexes it was found that most cases of ST-segment changes were accompanied by T-wave changes (72% of patients). With the use of traditional indexes 23% of patients showed no changes in the repolarization period, whereas with global indexes this percentage decreased to 8%. Thus a global representation of the entire ST-T complex appears to be more suitable than local measurements when studying the initial stages of myocardial ischemia.

Full Text

Cited Authors

  • García, J; Lander, P; Sörnmo, L; Olmos, S; Wagner, G; Laguna, P

Published Date

  • August 1998

Published In

Volume / Issue

  • 31 / 4

Start / End Page

  • 271 - 292

PubMed ID

  • 9731269

Pubmed Central ID

  • 9731269

Electronic International Standard Serial Number (EISSN)

  • 1090-2368

International Standard Serial Number (ISSN)

  • 0010-4809

Digital Object Identifier (DOI)

  • 10.1006/cbmr.1998.1481


  • eng