Dispersion ECG mapping in assessment of cardiovascular disease prevalence

Aim. To evaluate the potential of dispersion ECG mapping (ECG-DM) in diagnosing cardiovascular disease (CVD) and general health problems (GHP) during the screening examination of various population groups. Material and methods. In total, ECG-DM was performed in 1000 Uryupinsk and Uryupinsk Region citizens (537 healthy people, 156 people with GHP, and 307 people with CVD). In 84 participants, ECG-DM was performed before and after a simple stress test (20 squats). Additional examination of 21 CVD patients was performed before Results. An optimal cut-off for separating “norm” and “pathology” was 15 % level of “myocardium” parameter (sensitivity 75,6 %, specificity 80,3 %). For differentiation between CVD and GHP, this parameter had specificity of 58,3 % and sensitivity of 68,4 %. Out of 537 “healthy” people, in 39 (7,3 %) “myocardium” parameter was elevated, and an additional examination revealed CVD. In all participants (n=1000), no correlation between “myocardium” parameter and age, gender, cholesterol, blood pressure, or heart rate levels was observed, which points to its independent value in CVD diagnostics. A combination of ECG-DM and stress test improved sensitivity. Negative changes in ECG-DM parameters after stress test reflect changes in myocardial electrophysiology, and should not be regarded as direct evidence of myocardial ischemia. During the treatment of CVD patients, an improvement in ECG-DM parameters was associated with subjective improvement in patients’ well-being. Conclusion. ECG-DM method could be recommended for various screening programs, to identify people in need for additional examination because of potential CVD and other pathology

Myocardial functional status in patients with arterial hypertension and hyperaldosteronism: orthogonal electrocardiography assessment

Aim. To study orthogonal electrocardiography (ECG) parameters among arterial hypertension (AH) patients, in regard to renin-angiotensin-aldosterone system (RAAS) functional status. Material and methods. The study included 41 AH patients, mean age 45±2.8 years, and control group of 41 healthy individuals, mean age 41±7 years. Plasma aldosterone concentration (PAC) and plasma rennin activity (PRA) were measured at rest and after 4-hour walking. In all participants, 12-lead ECG and orthogonal ECG were registered, assessing left ventricular hypertrophy (LVH) criteria: Sokolow-Lyon criterion, Cornell index, Rx+Sz summary index, and repolarization acceleration vector module (G). Results were compared with echocardiography (EchCG) signs of LVH. Results. All patients had low-renin AH with various PAC levels. Three groups were identified: Group I (n=16), with adrenal cortex aldosteroma; Group II (n=12), with adrenal cortex hyperplasia; Group III (n=13), with normal PAC and no adrenal pathology. Comparing to Groups II and III, Group I had higher levels of systolic and diastolic blood pressure (BP), as well as more pronounced hyperaldosteronemia and hypokaliemia (p<0.05). Mean Cornell index in Group III was significantly lower than in Group I: 1.6±0.2 vs 2.5±0.2 mV, respectively. G index in Group III (71±9 ms) was significantly greater than in Groups I (35±5 ms) or II (47±6 ms). Inter-group differences for other parameters were not observed. Conclusion. Patients with adrenal cortex aldosteroma had significantly higher BP levels, more pronounced hyperaldosteronemia, hypokaliemia, and ECG signs of LVH, comparing to Groups II or III