• The Transactions of The Korean Institute of Electrical Engineers
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• v.59 no.6
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• pp.1143-1149
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• 2010

In this study, we propose a novel method to detect and enhance the feature of ST-segment which offers the crucial information for the diagnosis of myocardial infarction and ischemia. With this aim, PQRST features of Electrocardiogram initially are detected and subsequently ST-segment are estimated. And Dynamic Time Warping(DTW) transformation is applied recursively to minimize the difference in time between ST-segments and calculate the minimum cumulative distance that decides the degree of similarity among ST-segments. As of the results, the inherent characteristic of ST-segment can be emphasized in terms of time parameter and thus the diagnostic features of a ST-segment can be revealed further.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.15 no.10
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• pp.2223-2230
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• 2011

ECG is used to diagnose heart diseases such as myocardial ischemia, arrhythmia and myocardial infarction. Particularly, myocardial ischemia causes the shape change of the ST segment, this change is transient and may occur without symptoms. So it is important to detect the transient change of ST segment through long term monitoring. ST segment classification algorithm for making diagnosis myocardial ischemia is presented in this paper. The first step in the ST segment shape classification process is to detect R wave point and feature points based adaptive threshold and window. And then, the suggested algorithm detects the ST level change, To classify the ST segment shape, the suggested algorithm uses the slope values of the four points between the S and T wave. The ECG data in the European ST-T database were used to verify the performance of the developed algorithm. The best correct rate was 99.40% and the worst correct rate was 68.48%.

• 제어로봇시스템학회:학술대회논문집
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• 2004.08a
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• pp.176-180
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• 2004

The ST-segment that the beginning part of T wave is the important diagnostic parameter to finding myocardial ischemia. Abnormal ST appears in two types. One is the level change, and the other is the pattern change. In this paper, we describe the monitoring of abnormal ST using PC based system. Hardware of this system consists of transmitter, receiver and PC. The function of transmitter is measuring ECG in three channels which are selected manually and transmitting the data to receiver by digital radio way. Connection with receiver and PC is by RS232C, and the data received on the PC is analyzed automatically by ECG analysis algorithm and saved to file. In the algorithm part for detecting abnormal ST, ST-segments are approximated by a polynomial. This method can detect all of the deviation and pattern change of ST-segment regardless the change in the heart rate or sampling rate. To gain algorithm reliability, the method rejects distorted polynomial approximation by calculation the difference between the approximated ST-segment and original ST-segment. In pre-signal processing, the wavelet transformation separates high frequency bands including QRS complex from the original ECG. Consequently, the process improves the performance of detecting each feature points.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.177-185
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• 1994

Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent coronary vasodilator with rapid onset of action, short half-life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed $^{99m}Tc$-MIBI imaging after intravenous Infusion of adenosine In 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during $^{99m}Tc$-MIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused Intravenously at a dose of 0.14mg/kg per minute lot 6minutes and $^{99m}Tc$-MIBI was injected at 3 minute. We then com-pared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased $90{\pm}19$ beats/minute in the group with ST depression compared with $80{\pm}16$ beats/minute in the group without ST depression(p<0.05). Baseline systolic blood pressure was significantly higher in the group with ST depression($152{\pm}27$ mmHg) than in the group without 57 depression($140{\pm}21$mmHg, p<0.05). Double product at baseline($10.90{\pm}2.77$ versus $9.55{\pm}2.34\;beats/minute{\times}mmHg$) and during adenosine infusion($12.72{\pm}3.89$ versus $10.83{\pm}2.98\;beats/minute{\times}mmHg$) were significantly higher in the group with ST depression(p<0.05). The incidence of anginal chest pain was also significantly higher in the group with ST depression(ST versus 29%, p<0.0001). The $^{99m}Tc$-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p<0.05). In patients with ST segment depression, there were more reversible perfusion defects than in patients without ST segment depression(83 versus 55%, p<0.05). The number of abnormal segments were significantly higher in the group with ST depression($3.05{\pm}2.01$ versus $1.51{\pm}1.45$, p<0.005). In patients with ST segment depression, there were more segments of reversible perfusion defects than in patients without segment depression($2.15{\pm}2.11$ versus $0.89{\pm}1.24$, p<0.05). There were no differences in the angiographic severity by vessel(p ; NS). We concluded that ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy with Intravenous adenosine is related to the severity of coronary artery disease.

• Journal of Life Science
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• v.19 no.1
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• pp.81-86
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• 2009

The purpose of the present study was to examine effect of 12 week regular aerobic exercise on ST-segment and QTc interval in middle age type 2 diabetes mellitus (T2DM) patients. The subjects consist of 13 type 2 diabetes mellitus (T2DM) patients in middle age men and all of them had no other complications. Subjects participated in aerobic exercise training for 12 weeks. They started to exercise for $20{\sim}60$ min at $60{\sim}80%$ of $HR_{max}$, (exercise intensity has been increased gradually) per day, $3{\sim}5$ times a week. The results were compared before and after. Weight and BMI, % body fat, fasting glucose, HOMA-IR, $_{peak}DBP$ were significantly decreased and $_{peak}HR$, $_{peak}VO_2$, exercisre time were significantly increased after 12 week aerobic exercise. Also, QTc interval and ST-segment were significantly decreased during at rest, peak exercise after 12 week aerobic exercise. Conclusionally, 12 week aerobic exercise may be improvement in decreased cardiovascular mortality factors (ST-segment) and abnormal autonomic dysfunction (QTc interval) and potentially increased exercise capacity.

• Science of Emotion and Sensibility
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• v.10 no.2
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• pp.147-154
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• 2007

Electrocardiogram(ECG) being the recording of the heart's electrical activity provides valuable clinical information about heart's status. Many researches have been pursued for heart disease diagnosis using ECG so far. However, electrocardio-graph uses foreign diagnosis algorithm in the con due to inaccuracy of domestic diagnosis results for a heart disease. This paper proposes ST-segment extraction technique diagnosing heart disease parameter from raw ECG data. As the ST-segment is used for prediction of Coronary Artery Disease, we can predict heart disease using classification approach in data mining technique. We can also predict patient's clinical characterization from patient clinical data.

• Journal of Korean Neurosurgical Society
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• v.42 no.3
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• pp.184-190
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• 2007

Objective : The authors retrospectively analyzed clinical and radiographic features of patients who developed symptomatic adjacent segment degeneration (ASD) that required re-operation. Methods : From 1995 to 2004, among 412 patients who underwent posterior lumbar fusion surgery, the authors experienced twenty-six patients who presented symptomatic ASD. Records of these patients were reviewed to collect clinical data at the first and second operations. Results : The patients were 9 males and 17 females whose mean age was $63.5{\pm}8.7$ years. Among 319 one segment and 102 multi-segment fusions, 16 and 10 patients presented ASD, respectively. Seventeen ASDs were noticed at the cephalad to fusion (65%), eight at the caudad (31%), and one at the cephalad and caudad, simultaneously (4%). All patients underwent decompression surgery. Nine patients underwent additional fusion surgeries to adjacent degenerated segments. In 17 patients who underwent only decompression surgery without fusion, the success rate was 82.4%. In fusion cases. the success rate was observed as 55.5%. There were no statistically significant factors to be related to development of ASD. However, in cases of multi-level fusion surgery, there was a tendency toward increasing ASD. Conclusion : Multi-segment fusion surgery could be associated with a development of ASD. In surgical treatment of symptomatic ASD, selective decompression without fusion may need to be considered as a primary procedure, which could reduce the potential risk of later occurrence of the other adjacent segment disease.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.243-249
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• 2021

A decrease in coronary blood flow leads to an imbalance between the supply of oxygen to the myocardium and its demand, and reversible or irreversible damage to the myocardium could occur depending on the severity of the resultant ischemia and the duration of the imbalance. This imbalance results in a cascade of ischemic reactions in the following order: metabolic abnormalities, diastolic dysfunction, systolic dysfunction, and electrocardiogram changes. Variant angina is caused by the closure of the coronary artery due to reversible coronary artery spasm, resulting in myocardial ischemia and subsequent chest pain as a clinical symptom. Variant angina may be observed as ST segment elevation in electrocardiogram measured when present in chest pain. However, 12-lead electrocardiogram performed after the patient's chest pain resolves does not help in the diagnosis. Since the duration of chest pain appears to be <15 minutes, it is important to perform the 12-lead electrocardiogram when clinical symptoms are present. If nitroglycerin is administered without performing 12-lead electrocardiogram by 119 pre-hospital paramedics, the chest pain would be resolved, making it impossible to identify changes in the ST segment. Before administration of nitroglycerin, changes in the ST segment must be recorded by performing 12-lead electrocardiogram.

• Journal of Biomedical Engineering Research
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• v.28 no.5
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• pp.665-675
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• 2007

The morphological change of ECG is the important diagnostic parameter to finding the malfunction of a heart. Generally ST segment deviation is concerned with myocardial abnormality. The aim of this study is to detect the change of ST in shape using a polynomial approximation method and the reference ST type. The developed algorithm consists of feature point detection, ST level detection and ST shape classification. The detection of QRS complex is accomplished using it's the morphological characteristics such as the steep slope and high amplitude. The developed algorithm detects the ST level change, and then classifies the ST shape type using the polynomial approximation. The algorithm finds the least squares curve for the data between S wave and T wave in ECG. This curve is used for the classification of the ST shapes. ST type is classified by comparing the slopes of the specified points between the reference ST set and the least square curve. Through the result from the developed algorithm, we can know when the ST level change occurs and what the ST shape type is.

• Journal of Preventive Medicine and Public Health
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• v.39 no.6
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• pp.485-492
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• 2006

Objectives : To measure the distribution of electrocardiographic ST segment depression, and evaluate its relationships with cardiovascular risk factors based on the cross-sectional studies within a rural Korean community Methods : This study analyzed 1,343 persons, over 40 years old, who participated in a baseline survey during 2002-2005; the exclusion criteria included: a past history of myocardial infarction and angina pectoris, and specific conduction abnormalities. A Standard 12 leads ECG was recorded using an FCP-2101 (Fukuda Denshi Co.). The ST segment depression was retrospectively measured by a physician, according to the Minnesota code classification. Results : ST segment depression was found in 3.6 and 6.4% of male and female participants, respectively. After adjusting for age, gender, smoking, physical activity and obesity differences, high blood pressure showed significant relations with ST depression in females (male ORs=2.67, 95% CI=0.85-8.50; female ORs=2.62, 95% CI=1.29-5.32) Conclusions : As an ischemic ECG sign, ST depression was related to hypertension in female participants. This relationship remained significant, even after cases with left ventricular hypertrophy were removed.