Feasibility of a three-axis epicardial accelerometer in detecting myocardial ischemia in cardiac surgical patients Per Steinar Halvorsen, MD, Andreas.

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Presentation transcript:

Feasibility of a three-axis epicardial accelerometer in detecting myocardial ischemia in cardiac surgical patients Per Steinar Halvorsen, MD, Andreas Espinoza, MD, Lars Albert Fleischer, MSc, Ole Jakob Elle, MSc, PhD, Lars Hoff, MSc, PhD, Runar Lundblad, MD, PhD, Helge Skulstad, MD, PhD, Thor Edvardsen, MD, PhD, Halfdan Ihlen, MD, PhD, Erik Fosse, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 136, Issue 6, Pages 1496-1502 (December 2008) DOI: 10.1016/j.jtcvs.2008.08.043 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Schematic illustration of anterior view of left ventricle showing 3-axis accelerometer placed in left anterior descending coronary artery (LAD) perfusion area. Epicardial systolic wall motions are indicated with arrows; for 3-axis accelerometer, x arrow specifies longitudinal epicardial wall motion, y arrow specifies circumferential wall motion, and z arrow specifies radial wall motion. Level of occlusion of left anterior descending coronary artery is also indicated. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1496-1502DOI: (10.1016/j.jtcvs.2008.08.043) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Representative left ventricular curves from single patient of accelerometer circumferential velocity and acceleration, echocardiographic 2-dimensional strain, and electrocardiography (ECG) at baseline, during ischemia, and after reperfusion. Peak systolic velocity (Vsys) and velocity in isovolumic relaxation phase (Vivr) are indicated. Isovolumic relaxation phase is indicated by lines and defined within distinct spikes in acceleration signal caused by aortic valve closure and mitral valve opening. During ischemia, greatest changes can be seen in accelerometer velocity and strain curves, whereas no changes in electrocardiography can be seen. LAD, Left anterior descending coronary artery. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1496-1502DOI: (10.1016/j.jtcvs.2008.08.043) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Echocardiographic circumferential 2-dimensional (2D) strains and accelerometer circumferential peak systolic velocities at baseline, left anterior descending coronary arterial (LAD) occlusion, and reperfusion for all patients. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1496-1502DOI: (10.1016/j.jtcvs.2008.08.043) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Correlation between echocardiographic circumferential 2-dimensional (2D) strains and accelerometer circumferential peak systolic velocities for left anterior descending coronary arterial and left internal thoracic arterial occlusions. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1496-1502DOI: (10.1016/j.jtcvs.2008.08.043) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions