To evaluate the clinical utility of the spatial velocity electrocardiography (SVECG)-QRS complex in the diagnosis of dilated cardiomyopathy (DCM), studies were carried out on a series of 120 subjects divided into 5 groups. The two peaks of the SVECG-QRS complex pi-Mag and p2-Mag) were significantly depressed in the DCM group, compared to all other groups, that is, 30 normal subjects (p < 0.05, p < 0.01), 26 patients with aortic regurgitation and mitral regurgitation (p < 0.01, p < 0.01), 18 patients with diffuse hypertrophy (p < 0.01, p < 0.01), and 19 patients with cardiac dysfunction and ischemic heart disease with ventricular dilatation (p < 0.01, p < 0.05). Decrease in SVECG-QRS wave height in DCM patients is considered specific for DCM. When 26 DCM patients were divided into a subgroup [ventricular tachycardia, VT(+)] of 11 patients with a history of monomorphic VT (5*6 consecutive ventricular complexes occurring at a rate of 100 beats/min) and a subgroup [VT(-)] of 15 other DCM patients, pi-Mag was significantly depressed in the VT(+) subgroup compared to the VT(-) subgroup (71.5 ± 27.0 versus 97.2 ±31.2 mV/s, p < 0.05), and p2-Mag tended to be lower in the VT(+) subgroup (93.3 ± 39.9 versus 100.3 ± 34.0 mV/s). Both pl-Mag and p2-Mag were markedly depressed in the DCM patients who were claimed by VT. These data suggest that: (1) decrease in SVECG-QRS wave height is a new ECG sign of DCM; (2) marked depression in SVECG-QRS wave may be an important sign in predicting progress in DCM.

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Chiharu IBUKIYAMATo obtain an overall view of the QRSloop on vectorcardiograms (VCG)of hypertrophic cardiomyopathy (HCM),the coordinate axis was transformed using the resolver method. The morphological features and planarity of the loop were compared with hypertrophic patterns and hypertensive heart disease (HHD). The subjects in the present study included 30 normal individuals, 40 patients with HCMand 30 with HHD. The HHDgroup was selected from patients showing left ventricular hypertrophy on VCGsimilar to that of HCM patients. The HCMgroup showed significantly greater values than the HHDgroup in the thickness/length ratio, which represents the planarity of the spatial QRSloop. The above finding suggests that the HCMgroup had greater deformation in the QRS loop than the HHDgroup. This may provide a useful indicator for the differential diagnosis of the two diseases.