The Spatial Ventricular Gradient Is an Independent Predictor of Anthracycline-Associated Cardiotoxicity

Spatial Ventricular Gradient

“…In summary, the study by Rosas Diaz et al 15 provided critical new data supporting the importance of vectorcardiographic measurements. Notably SVG measurements are reproducible not only in sinus rhythm but also in atrial fibrillation and ventricular pacing, as demonstrated in a large prospective study.…”

“…In this issue of JACC: Advances , Rosas Diaz et al 15 for the first time reported an association between SVG magnitude and risk of anthracycline cardiotoxicity. The authors conducted large retrospective cohort study of patients treated with anthracyclines.…”

“…Notably, SVG measurements included an important step of detection of the origin of the heart vector, as first described by Perez-Alday et al. 16 The findings of Rosas Diaz et al 15 are clinically important. In competing risk analysis, a larger SVG magnitude was robustly associated with reduced risk of incident heart failure/cardiomyopathy.…”

“…One particular limitation of the study deserves special comment. In addition to the SVG magnitude, Rosas Diaz et al 15 reported 3 planar, 2-dimensional components of the SVG: ventricular gradients on X, Y, and Z orthogonal ECG lead. The authors attempted to interpret the magnitude of a VG on one of the orthogonal leads (X, Y, and Z) as a proxy for the direction of SVG.…”