DIELECTRIC SPECIFICS OF THE BLOOD IN UNSTABLE ANGINA: NEW ADDITIONAL TEST FOR ACUTE MYOCARDIAL ISCHEMIA DIAGNOSTICS

Aim. To study blood dielectric properties of patients with unstable angina (UA) for the development of novel additional diagnostic criteria for acute myocardial ischemia.

Material and methods.   Totally, 61 patient studied with non-ST-elevation acute coronary syndrome (NSTEACS), of those 40 patients having on ECG the changes of ischemic type, 21 patient with ACS without ECG changes. In all patients troponin T was negative in single measurement. Comparison group consisted of the stable angina patients II FC (n=13). Controls consisted of 30 healthy donors of blood transfusion center; to 59% patients with preliminary diagnosis NSTEACS (n=61) diagnostic coronary angiography was don (CAG). To all patients we performed study of dielectric properties of the blood by the Fourier-spectroscopy method.

Results.   Dielectric properties of the blood in NSTEACE/UA, during the first hours of pain onset significantly differ from those in stable angina and controls. In 26% of patients dielectric properties of the blood get back later than positive changes of ECG occur (ST return to isoline).

Conclusion. Diagnostic test for acute myocardial ischemia, together with ECGdiagnostics and clinical picture makes it possible, in short time, to perform expressdiagnostics of myocardial ischemia when NSTEACS/UA is suspected, especially in comorbidity patients having the same ST depression on ECG, caused by LV hypertrophy.

1. Oganov RG, Koncevaja AV, Kalinina AM. Economic Burden of Cardiovascular Diseases in the Russian Federation. Cardiovascular Therapy and Prevention 2011; 10 (4): 4-9. Russian (Оганов Р.Г., Концевая А.В., Калинина А.М. Экономический ущерб от сердечнососудис тых заболеваний в Российской Федерации. Кардиоваскулярная терапия и профилактика 2011, 10 (4): 4-9).

2. Braunwald E., Morrow D. A. Unstable angina: is it time for a requiem? Circulation 2013; 27: 2452-7.

3. Vel’kov VV. Highly sensitive measurement of cardiac troponin: test which saves lives. Clinical and laboratory consultation. Scientific journal 2012; 1 (41): 47-52. Russian (Вельков В. В. Высокочувствительное измерение кардиальных тропонинов: тест, который спасает жизни. Клинико-лабораторный консилиум. Научно-практический журнал 2012, 1 (41): 47-52).

4. Hamm CW, Bassand JP, Agewall S, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal 2011; 32: 2999-3054.

5. Malahov MV, Mel’nikov AA, Nikolaev DV, et al. Correlation of bioimpedance spectroscopy of blood with her staff. Materials XII scientific and practical conference “Diagnosis and treatment of disorders of the regulation of the cardiovascular system” Moscow: 2010. p. 224-6. Russian (Малахов М. В., Мельников А. А., Николаев Д. В. и др. Взаимосвязь показателей биоимпедансной спектроскопии крови с ее составом. Мат. XII научнопракт. конф. “Диагностика и лечение нарушений регуляции сердечно-сосудистой системы”. НТЦ Медасс. ГКГ МВД РФ. Москва; 2010. с. 224-6).

6. Nicolson AM, Ross GF. Measurement of the Intrinsic Properties of Materials by TimeDomain Technique//IEEE Transaction.1970; 19: 377-82.

7. Vykoukal DM, Gascoyne PR, Vykoukal J. Dielectric characterization of complete mononuclear and polymorphonuclear blood cell subpopulations for label-free discrimination. Integr.Biol. (Camb). 2009; 7: 477-484.

8. Asami K, Sekine K. Dielectric modelling of erythrocyte aggregation in blood. J. Phys. 2007; 40: 2197-204.

9. National guidelines for treatment of acute coronary syndromes without persistent ST elevation on ECG. Cardiovascular Therapy and Prevention 2006; 8(5), Suppl. 1. Russian (Лечение острого коронарного синдрома без стойкого подъема сегмента ST на ЭКГ. Российские рекомендации. 2006; 8(5), Приложение 1).

10. Patent RF № 2012108346/15, 05.03.2012 Grinshtein YuI, Andina LA, Suhovol’skij VG, et al. A method for diagnosing acute coronary syndromes without ST-segment elevation on the ECG. Patent Rossii № 2482488, 2013, Bjul. № 14. Russian (Патент РФ № 2012108346/15, 05.03.2012 Гринштейн Ю.И., Андина Л.А., Суховольский В. Г. Способ диагностики острого коронарного синдрома без подъема сегмента ST на ЭКГ. Патент России № 2482488. 2013; Бюл. № 14).

11. Andina LA, Kovalev AV, Grinshtein YuI, et al. Dielectric Fourier-spectroscopy in the express-diagnosis of acute coronary syndrome without ST-segment elevation on ECG at negative troponin test. Siberian Medical Review 2013, 1: 32-6. Russian (Андина Л. А., Ковалев А. В., Гринштейн Ю. И. и др. Диэлектрическая Фурье-спектроскопия в экспресс-диагностике острого коронарного синдрома без подъема сегмента ST на ЭКГ при отрицательном тропониновом тесте. Сибирское медицинское обозрение 2013, 1: 32-6).

12. Koul KS. The nerve impulse (theory and experiment). The theoretical and mathematically biology. M.: Mir; 1968. рр. 154-93. Russian (Коул К. С. Нервный импульс (теория и эксперимент). Теоретическая и математическая биология. М.: Мир, 1968; 154-93).

13. Pollard Dzh. Handbook of computational methods of statistics. Moscow: JoJo Media; 2012. p. 173. Russian (Поллард, Дж. Справочник по вычислительным методам статистики. М.: ЁЁ Медиа; 2012. с. 173).