The first thing to keep in mind is that “Digital Cardiology” (DC), has nothing to do with "digital medicine" - a popular term that media workers have created to describe Holter devices, medical gadgets and remote and telemedicine devices. DC is an independent "breakthrough" diagnostic technology consisting of four basic provisions:
- methodically - DC (simultaneously) uses the analysis of both ECGs - both analog and digitized, as a result of which new parameters of the myocardium and coronary vessels appear.
- the theoretical foundations of the DC are formulas that reflect the physical (not electrical, as in a conventional, analog ECG), the laws of the heart.
- the medical aspect is that the DC allows you to create new (virtual) tools for analyzing cardiac activity, allowing you to obtain fundamentally new information about the work of the heart, which cannot be obtained in any other way.
- the instrument aspect of the DC is that in order to implement this diagnostic technique in the clinic, cardiographs and stress systems of a new generation are required, the requirements for which the DC specifically formulates.
The foundations of the DC were laid approximately 40 years ago, when it became clear to some cardiologists that everything that was in it had been extracted from an analog ECG for 150 years and fundamentally different devices were needed for the progress of cardiology, allowing to obtain deeper and more detailed information about the work of the heart. And, as soon as the ADC (analog-digital converter) appeared, cardiologists familiar with mathematics began to look for mathematical methods for analyzing the digitized ECG, which was a series of periodically repeating numbers. As a result, a system of formulas for analyzing the digitized ECG was born first, and then an idea of a device that allows this to be done was already formed.
The theoretical part of the DC is the mathematical apparatus that is used by 2-nd generation stress systems to analyze digitized ECG, and the practice is to combine the analysis of both types of ECG with bicycle test on a 2-nd generation stress system. That is, a stress system with an extended interface.
At the DC, for the first time when decoding an ECG, not only its visible record (analog ECG) is analyzed, but also its invisible - digitized ECG, which makes it possible to create virtual instruments for a comprehensive analysis of the activity of the heart and impressive possibilities of their application. Since only digitized ECG data is suitable for any calculations that operate on the dimensions of ECG elements. as absolutely accurate, taking into account the third and sometimes the fourth decimal place, which cannot be obtained in an analog ECG. Only digitized ECG data is suitable for analysis. Digital cardiology does not use visual assessments of an analog ECG, but recognizes only accurate figures that allow the use of quantitative methods.
Digital cardiology arose due to the advent of ADC, as well as mathematics with programming, allowing to obtain all its characteristics from the ECG, and the transition from traditional cardiology to digital will not be quite simple, since it requires some knowledge of mathematics. However, computer programs and diagnostic stands of digital cardiology will be available to everyone, which subscribers or users can work with even without knowledge of mathematics.
DC is a significant step in the development of ECG analysis in obtaining more information hidden in it. And, in this sense, digital cardiology is, of course, a "breakthrough technology", although at the same time, it is a natural continuation of classical cardiology, where some concepts are indicated by numerical values, and reasoning is replaced by calculations. Hence the ability of the DC to solve the problems that traditional cardiology could not solve, replacing the evaluation diagnostic methods with computational ones. For example, without access to a digitized ECG, safe bicycle test is also impossible, just as correct diagnosis of coronary heart disease is impossible without a digitized ECG. Like all other, more complex procedures, such as determining the biological age of the myocardium or calculating its anti-infarction buffer.
But, most importantly, it is only thanks to the digitized ECG that the clinic receives such a powerful tool of the DC as the "colorogram". It can be said that if the main diagnostic method of classical cardiology is bicycle test (VEM) - obtaining an ECG with a sign of myocardial ischemia on a bicycle test (depression of the segment ST = 2mm.), which is obtained on existing stress systems, giving patients a load. In order to get a "color chart", we need an already upgraded stress system - a 2-nd generation stress system. With a wider interface, in which you can enter ECG analysis formulas and plotting coordinates. But the diagnostics itself proceeds here as a classical bicycle test - with the same loads and the same time intervals as in the classical bicycle test.
But if classical bicycle test writes only an ECG, then in digital cardiology, along with an ECG, a graph of the state of the myocardium is also written - its energy state, after the work done by it in the cardiocycle. The energetic state of the myocardium after the work performed by it is evaluated in each cardiocycle as the real capabilities of the myocardium, with an assessment in color:
- green, if after the work performed by the myocardium, the myocardium is in a state of ideal norm
- yellow, if after the work performed by the myocardium, the myocardium is in a state of physiological norm,
- orange, if after the work performed by the myocardium, the myocardium is in a state of disadaptation or "pre-pain",
- red, if after the work performed by the myocardium, the myocardium is in a state of pathology, that is, acute ischemia.
- black, if after the work performed by the myocardium, the myocardium is in a state incompatible with life.
(It is clear that the last load cannot be offered to the patient. That such a load will be next, the stress system warns the doctor with an audible signal, stops offering loads to the examinee and switches to the "waiting for the command" mode)
As a result, the DC receives a "color chart" - a graph of changes in the energetic (and clinical) state of the myocardium under load, where a color spot is given an assessment of the state of the myocardium in each cardiocycle. This is an integral indicator of the state of the myocardium and coronary vessels in a given person at a given time. However, it is also a powerful tool for the study of the entire cardiovascular system, obtained as a result of the analysis of the digitized ECG
The mathematical analysis of the digitized ECG allows the doctor to obtain a unique indicator in its capabilities, which has:
- incredible sensitivity. Reacting to the patient, who takes a sip of coffee. And especially to anybody will take strong drugs.
- the configuration of the "colorogram" is capable of transmitting the number of states of the human cardiovascular system, which can be expressed by a number with 60 zeros, which allows you to use the "colorogram" as an archive-analog form for recording on the "colorogram" the results of other methods of studying the cardiovascular system and coronary vessels. In particular, coronary angiography, which, thanks to the "colorogram", can be performed in a completely bloodless way.
This complex team examination on multi-ton equipment requiring special energy and premises can be equivalent to replacing routine bicycle test with a color chart? Which can be carried out on a distant ship in the Arctic ice, on a distant drilling platform in a raging ocean, to an astronaut on a space station and even to passengers and a pilot in a flying liner. This unique property allows us to use the "color chart" on several levels - both as an individual characteristic of the condition of a given myocardium at the moment, and as its energy matrix for comparing the same myocardium with its condition in the past and in the future - both without treatment and during treatment. According to her, it becomes real:
1..To find out not the passport, but the real - biological age of the myocardium.
2. Quickly find the most effective drug for each patient.
3. Identify substances (drugs, doping, etc.) that were taken with an indication of the approximate time and doses.
4. To give a prognosis about the duration of this myocardial condition to cardiac surgeons.
6. Determines the intake of drugs, doping, stimulants and narcotic substances by the subject.
7. In sports, clinic, at home, it can be an intelligent simulator and an expert system.
The color chart has several levels of intelligence:
FEATURES OF THE COLOR CHART
1. Provides absolute safety of the bicycle test in which the stress system does not offer patients "critical" loads for them, warning the doctor about them.
2. Constantly informs the doctor about the state of the myocardium at rest and during exercise.
3. Provides information about the total, coronary, aerobic and anaerobic resources of the myocardium.
4. Sound (or light) warns the doctor if the next load will be "critical" for the examinee.
5. Determines the effectiveness of a therapeutic drug by its direct effect on the myocardium.
The first is a mathematical model that evaluates the state of the myocardium in parallel with the ECG and constantly reports on the state of the myocardium on the bicycle test:
The second level is the assessment of the "color chart" according to the arrays created by it: both age standards of the norm, and samples of taking certain drugs (any), as age samples of pathologies of the cardiovascular system
The third level is implemented in training the stress system to operate with complex arrays combining 2 or more methods - to determine the affected coronary artery, its level, and the nature of the lesion from the color chart.
The fourth level of intelligence is realized after connecting several such stress systems into a network. City, district, region, State, country, etc.
AREAS OF APPLICATION OF THE COLOR CHART
- able to evaluate each load of the ECG cardiocycle in one of 5 clinical gradations (absolute norm, physiological norm, pre-disease, pathology, danger to life) by reporting each assessment in a certain color. Which allows:
- makes possible the production of watches and simulators, not only constantly showing the condition of the coronary vessels and myocardium, but also informing doctors, medical institutions, ambulance, superiors about it.
- can carry out continuous medical monitoring of the condition of operators of complex expensive devices (spaceships, ships, airplanes, walking excavators, tunneling complexes, coal harvesters, cars, etc.), constantly reporting their condition to the dispatcher or transfer control from him to the system that takes control of the mechanism in case of violation of the operator's health, informing it.
- during the test, it constantly reports on the state of the myocardium in color, and the study is presented in the form of a color curve, which is a PASSPORT of the MYOCARDIUM, which presents all indicators of its protective resources – aerobic, anaerobic, ischemic. Which in total characterizes the ANTI - ISCHEMIC BARRIER.
- can serve as an individual marker of a high level - the probability of a match is 1:81,000,000,000,000, (1000 times higher than a fingerprint), which makes it possible to determine the biological age of the myocardium for cardiologists and cardiac surgeons.
- shows the reaction of the myocardium to the minimum doses of medicinal, psychotropic, narcotic and other substances (1-2 sips of coffee) both immediately after their reception by the patient and with their regular use. .
- it can create highly ranked databases of "colorograms" with other types of expensive dangerous studies - angiography of coronary vessels, for example – which allows, already with a database of 1000 images, to receive during the test also pictures of the coronary arteries of its statistical twin. He himself, at the same time, did not undergo coronary angiography.