Vectorcardiographic Studies in Acquired Valvular Disease with Reference to the Diagnosis of Right Ventricular Hypertrophy

Cueto, J.; Toshima, Hironori; Armijo, Germán; Tuna, Naip; Lillehei, C. Walton

doi:10.1161/01.cir.33.4.588

Cited by 30 publications

(3 citation statements)

References 12 publications

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“…These chaniges were of course more pronovunced in the cases with moderate and severe degrees of right ventricular hypertrophy. 17 In our study we did not find significant correlations between magnituide of the spatial vectors and pressure gradients similar to the ones described by Hugenholz and Gamboa1 " for congenital heart disease, but it must be remembered that congenital heart disease differs greatly from our group with acquired heart disease in the following points: (1) The group with congenital heart disease studied had only a single lesion.…”

Section: Discussionsupporting

confidence: 75%

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Vectorcardiographic Studies in Acquired Valvular Disease

1967

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A vectorcardiographic study using the Schmitt-Simonsen (SVEC-II) method was done in 92 patients with mitral and aortic acquired valvular disease in which left ventricular hypertrophy and the valvular lesions were proven by means of right and left heart catheterization, operation, or autopsy, or by all methods. Significant differences were found among groups with aortic insufficiency, aortic stenosis, and mitral insufficiency. The magnitude of the 0.01 and 0.02-sec and maximal spatial vectors and the voltages of the Qx R, as well as R, waves were greatest in the group with aortic insufficiency. The greatest voltages of the 0.03-sec and 0.04-sec vectors were found in patients with aortic stenosis. In this study the smaller voltages after the 0.03-sec vector were found in the group with mitral insufficiency, and these voltages were significantly increased when aortic insufficiency complicated the picture. Groups with aortic insufficiency and mitral insufficiency, or aortic stenosis or insufficiency and mitral stenosis showed abnormal inferior orientation of the middle and terminal forces, which were explained upon the basis of the concomitant right ventricular hypertrophy. The authors believe that with the aid of the corrected orthogonal system of Schmitt and Simonsen (SVEC-III) the clinician will be able not only to make a more accurate evaluation of left ventricular hypertrophy, but also in many instances will find considerable assistance in arriving at a specific clinical diagnosis.

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Section: Discussionsupporting

confidence: 75%

“…However, the depth of the S wave was considerably decreased in the group complicated with mitral stenosis (V) and supposedly with right ventricular hypertrophy. 17 Lead Z. In lead Z the R wave in the group with AI (I) was greatest.…”

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Vectorcardiographic Studies in Acquired Valvular Disease

1967

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“…Application of P wave criteria required exclusion of patients with atrial fibrillation resulting in a smaller test sample, thus necessitating a decrease in the number of parameters that could be validly used. 9 The use of P wave criteria resulted in significant improvement in separation between normal and MS (45 to 60%) and between PE and MS (48 to 63%). No improvement in recognition rate with rising pulmonary artery pressure was seen in the separation of pulmonary emphysema from mitral stenosis using five QRS criteria alone (table 6).…”

Section: Multivariate Analysismentioning

confidence: 95%

Computer Analysis of the Orthogonal Electrocardiogram and Vectorcardiogram in Mitral Stenosis

Walston¹,

Harley²,

Pipberger³

1974

Circulation

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Orthogonal electrocardiograms (Frank lead system) from 191 patients with pure mitral stenosis (MS) were compared to electrocardiograms from 510 normal patients and 296 patients with pulmonary emphysema (PE). All patients with MS underwent right heart catheterization; 121 patients underwent both left and right heart catheterization. Three hundred and thirty electrocardiographic measurements were obtained from each record and tested for their ability to distinguish mitral stenosis from normal. Two sets of diagnostic discriminators were selected: (1) ECG measurements which can be easily obtained by hand and (2) measurements which performed best in multivariate analysis using linear discriminant functions. The patients with mitral stenosis were separated into three hemodynamic subgroups according to mean pulmonary artery pressure (PAP) (0-30, 31-40, and >40 mm Hg). The ability of the selected measurements to recognize mitral stenosis increased as mean pulmonary artery pressure rose. The superiority of the multivariate technique, using nine measurements simultaneously, was readily demonstrated when compared to the hand measurements. At a constant level of 6% false positives, multivariate analysis allowed a 74% recognition rate of mitral stenosis compared to 44% with hand measurements. Additional Indexing Words: Digital computerMultivariate analysis Right ventricular hypertrophy THE SALIENT FEATURES of both the electrocardiogram (ECG) and vectorcardiogram (VCG) in patients with mitral stenosis have been previously described by a number of investigators.'1"0 In general, it is concluded that the usefulness of the ECG and VCG for the diagnosis and assessment of the severity of mitral stenosis remains modest. The cancellation of right ventricular forces by opposing left ventricular forces does not allow the ECG characteristics of right ventricular hypertrophy (RVH) to be manifest until the RVH is marked. This in part explains the lack of sensitivity of the standard ECG and VCG in detecting mild or moderate mitral stenosis (MS). It has been demonstrated previously that computer analysis of the From the Veterans Administration Cooperative Study on

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The Evaluation of Patients for Prosthetic Valve Implantation

Frankl¹

1985

Guide to Prosthetic Cardiac Valves

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Vectorcardiographic Studies in Acquired Valvular Disease with Reference to the Diagnosis of Right Ventricular Hypertrophy

Cited by 30 publications

References 12 publications

Vectorcardiographic Studies in Acquired Valvular Disease

Vectorcardiographic Studies in Acquired Valvular Disease

Computer Analysis of the Orthogonal Electrocardiogram and Vectorcardiogram in Mitral Stenosis

The Evaluation of Patients for Prosthetic Valve Implantation

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