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Biomedical subjects

F Kornreich

Publications and source records attributed to F Kornreich.

At least 37 records · Page 2Linked to original sources

Cardiac effects of common viral illnesses.

We compared the clinical, electrocardiographic and echocardiographic findings of 32 patients during the acute and recuperative phases of viral illness with similar data from a healthy age- and sex-matched normal control group. During the acute phase, no patient had cardiac symptoms and none had clinical evidence of left ventricular or valvular dysfunction, nor pericarditis. Electrocardiograms revealed no differences in mean sinus rate or ectopic dysrhythm between the two groups. Spatial 12- and 120-lead body surface electrocardiographic patterns were normal in 30 patients; two others had nonspecific T wave abnormalities. There were no differences in echo-determined left ventricular cavity size or systolic shortening fraction between the two groups. Three patients had segmental ventricular hypokinesis; 17 patients had small pericardial effusions. Data herein suggest effects on myocardial electrical and mechanical function in patients with viral illness. It may be prudent for such patients to minimize cardiac stress during illness.

Acute Disease↗

Qualitative and quantitative analysis of characteristic body surface potential map features in anterior and inferior myocardial infarction.

Body surface potential maps were recorded from 120 electrode sites in 236 normal subjects and 258 patients with initial evidence of either anterior myocardial infarction (MI) or inferior MI to identify characteristic map patterns in both groups. After time normalization, averaged map distributions were displayed at 18 equal time intervals during both QRS and ST-T waveforms from the normal, anterior MI and inferior MI groups. At each time instant, the 120-point averaged normal map was subtracted in turn from the corresponding anterior and inferior MI maps; the resulting differences at each electrode site were divided by the pooled standard deviation and the obtained values (discriminant indexes), plotted as contour lines with 1 standard deviation increments, producing discriminant maps for each bi-group comparison. The most consistent discriminant patterns in 114 patients with anterior MI were observed in early QRS in the upper left anterior chest where abnormal negative voltages reflected loss of electric potentials while reciprocal changes were noticed in the lower back; by mid-QRS, both distributions had moved jointly and vertically, the former in the lower torso on the midsternal line, the latter in the upper back. In 144 patients with inferior MI, abnormal positive distributions were observed in early QRS in the upper back, followed later by excessive negative voltages in the inferior right anterior chest; at mid-QRS, both distributions had migrated horizontally, the former proceeding toward the upper anterior torso, the latter to the lower left dorsal area.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Identification of best electrocardiographic leads for diagnosing anterior and inferior myocardial infarction by statistical analysis of body surface potential maps.

In view of the increasing interest in quantifying and modifying the size of myocardial infarction (MI), it is important to look for clinically practical subsets of electrocardiographic leads that allow the earliest and most accurate diagnosis of the presence and electrocardiographic type of MI. A practical approach is described, taking advantage of the increased information content of body surface potential maps over standard electrocardiographic techniques for facilitating clinical use of body surface potential maps for such a purpose. Multivariate analysis was performed on 120-lead electrocardiographic data, simultaneously recorded in 236 normal subjects, 114 patients with anterior MI and 144 patients with inferior MI, using as features instantaneous voltages on time-normalized QRS and ST-T waveforms. Leads and features for optimal separation of normal subjects from, respectively, anterior MI and inferior MI patients were selected. Features measured on leads originating from the upper left precordial area, lower midthoracic region and the back correctly identified 97% of anterior MI patients, with a specificity of 95%; in patients with inferior MI, features obtained from leads located in the lower left back, left leg, right subclavicular area, upper dorsal region and lower right chest correctly classified 94% of the group, with specificity kept at 95%. Most features were measured in early and mid-QRS, although very potent discriminators were found in the late portion of the T wave.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗

Identification of best electrocardiographic leads for diagnosing myocardial infarction by statistical analysis of body surface potential maps.

This study describes a practical approach for the extraction of diagnostic information from body surface potential maps. Body surface potential map data from 361 subjects were used to identify optimal subsets of leads and features to distinguish 184 normal subjects from 177 patients with myocardial infarction (MI). Multivariate analysis was performed on 120-lead data, using as features instantaneous voltage measurements on time-normalized QRS and STT waveforms. Several areas on the map, most of which were located outside the precordial region, contained leads with important discriminant features; 2 of the 3 limb leads (aVR and aVF) also exhibited high diagnostic capability. A total of 6 features (mostly STT measurements) from 3 locations accounted for a specificity of 95% and a sensitivity of 95%; these were the right subclavicular area, the left posterior axillary region and the left leg. As a comparison, the same number of features from the standard 12-lead electrocardiogram yielded a sensitivity of 88% for a specificity of 95%. To investigate the repeatability of the results, the entire population was separated into a training set (100 normal subjects and 100 patients with MI) and a testing set (84 normal subjects and 77 patients with MI); computing a discriminant function on the training set and applying it to the testing set only moderately deteriorated the diagnostic classification. It is concluded that this approach achieves efficient information extraction from body surface potential maps for improved diagnostic classification.

Adult↗

Effective extraction of diagnostic ECG waveform information using orthonormal basis functions derived from body surface potential maps.

A common basis of orthogonal waveform functions was derived from 128 lead body surface potential maps of 405 subjects. Twelve such orthogonal functions or frames were adequate for reconstruction of original ECGs from the beginning of QRS to the end of T. A larger number of frames (18) was required when basis functions were derived separately for QRS (10) and ST-T segments (8). Diagnostic information content of the coefficients of the orthogonal basis functions was evaluated in comparison with Minnesota Code criteria for myocardial infarction and with a more advanced multivariate ECG analysis program (Pipberger Program). This was done by deriving a linear discriminant function for separating normals from ECGs of patients with myocardial infarction and testing the discriminant in a different test population of infarcts and normals. The diagnostic accuracy of orthogonal basis functions was as good as that of Pipberger's program and considerably better than that of the Minnesota Code. The classification method described is insensitive to noise and errors in detecting QRS and T wave onsets and offsets or in selecting proper baseline for amplitude measurements. The robustness and enhanced classification stability with respect to noise and minor wave detection errors is a potential advantage particularly in serial ECG comparison.

Adult↗