Estimation of Myocardial Cell Damage on the Basis of Mean Electrocardiographic Voltage and Anatomical Left Ventricular Mass.

  • HANADA Koichi
    Second Department of Internal Medicine, Yokohama City University School of Medicine Department of Public Health, Yokohama City University School of Medicine
  • TOCHIKUBO Osamu
    Department of Public Health, Yokohama City University School of Medicine
  • SHIGEMASA Tomohiko
    Division of Cardiology, Yokohama City University Medical Center
  • KIMURA Kazuo
    Division of Cardiology, Yokohama City University Medical Center
  • UMEMURA Satoshi
    Second Department of Internal Medicine, Yokohama City University School of Medicine

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Abstract

Left ventricular mass (LVM) as assessed by magnetic resonance imaging (MRI, LVMMRI) and electrocardiographic (ECG) voltage reflect different pathological features. We hypothesized that ECG voltage is related to the electrical potential of cardiac muscle cells (electrical LVM) and to anatomical LVM as evaluated by MRI, and that the divergence between electrical LVM and anatomical LVM reflects the degree of myocardial damage. Because adipose tissue has high electrical resistance, we previously found a very strong correlation between body-fat-corrected mean ECG voltage (Vfm) and LVM as estimated by echocardiography in patients with essential hypertension. In this study we compared LVMMRI, Vfm, the ratio of Vfm×102⁄LVMMRI, and the results of 99mTc tetrofosmin scintigraphy in patients with and without myocardial infarction (MI). We studied 33 patients without MI and 26 patients with MI. Vfm significantly correlated with LVMMRI in patients without MI (r=0.71, p<0.01). The ratio of Vfm×102⁄LVMMRI apparently reflected the relation between electrical LVM and anatomical LVM. Vfm×102⁄LVMMRI in patients with MI was smaller than that in patients without MI (0.98±0.28 vs. 1.42±0.29, p<0.01). Vfm×102⁄LVMMRI decreased as 99mTc score increased (r=-0.66, p<0.01). Our results indicate that Vfm is a useful index of electrical LVM and that Vfm×102⁄LVMMRI reflects the electrical potential of the viable myocardium in total anatomical LVM. (Hypertens Res 2002; 25: 19-24)

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