Summary: Cardiogoniometry is a new method to test heart function. It consists of a simple computerized vectorcardiography with a system of leads derived for the construction of three orthogonal projections. With the aid of these three-dimensional projections the cardiogoniometer, a microprocessor system, measures and computes the maximal vectors of depolariza.tion (~RS) and repolarization (T). It also fixes the OrIentatIon of these two spatial vectors by projection on two planes (frontal and oblique sagittal) and determines the solid angle q; between them. Every third heart beat these five parameters and the preceding beat interv~1 are ~rintc:

Cardiogoniometry (CGM), a spatiotemporal electrocardiologic 5-lead method with automated analysis, may be useful in primary healthcare for detecting coronary artery disease (CAD) at rest. Our aim was to systematically develop a stenosis-specific parameter set for global CAD detection. In 793 consecutively admitted patients with presumed non-acute CAD, CGM data were collected prior to elective coronary angiography and analyzed retrospectively. 658 patients fulfilled the inclusion criteria, 405 had CAD verified by coronary angiography; the 253 patients with normal coronary angiograms served as the non-CAD controls. Study patients--matched for age, BMI, and gender--were angiographically assigned to 8 stenosis-specific CAD categories or to the controls. One CGM parameter possessing significance (P < .05) and the best diagnostic accuracy was matched to one CAD category. The area under the ROC curve was .80 (global CAD versus controls). A set containing 8 stenosis-specific CGM parameters described variability of R vectors and R-T angles, spatial position and potential distribution of R/T vectors, and ST/T segment alterations. Our parameter set systematically combines CAD categories into an algorithm that detects CAD globally. Prospective validation in clinical studies is ongoing.

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Summary: Cardiogoniometry is a new vectorcardiographic method. The vector-loops are constructed from three orthogonal ECG leads and registered on-line by a microprocessor. The angle between the maximal QRS and T vectors, as well as the spatial orientation of these vectors are very constant in healthy individuals. Deviations of these vectors and angles are sensitive indicators for changes in repolarization occurring, for instance, during coronary insufficiency. The changes in these variables were evaluated in 50 patients with suspected coronary artery disease and correlated with angiographic findings. Cardiogoniometry showed a sensitivity of 79% and a specificity of 82%. which is comparable to exercise testing. In contrast to the latter cardiogoniometry can be performed at rest, is free of risk, and therefore also suitable for elderly patients.

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