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Value of vectorcardiography in predicting progress in dilated cardiomyopathy
1Second Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan.
Japanese Circulation Journal
|October 1, 1989
Summary
In dilated cardiomyopathy (DCM), specific QRS loop abnormalities in the horizontal plane, including posterior displacement, narrowness, distortion, or a figure-of-eight shape, indicate a poor prognosis for survival.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
- Prognostic indicators in DCM are crucial for patient management and risk stratification.
Purpose of the Study:
- To investigate the prognostic value of electrocardiographic (ECG) parameters, specifically QRS loop characteristics, in patients with DCM.
Main Methods:
- Retrospective analysis of 75 DCM patients with a mean follow-up of 39.7 months.
- Comparison of baseline clinical, hemodynamic, and ECG data between survivors and non-survivors.
- Detailed analysis of QRS and T vector magnitudes, angles, and QRS loop morphology in the horizontal plane.
Main Results:
- Mortality rate was 21.3% (16/75 patients).
- Non-survivors exhibited higher cardiothoracic ratio, elevated left ventricular end-diastolic dimensions and pressures, and lower cardiac index.
- Significant differences were observed in QRS loop morphology: posterior displacement, smaller width/length ratio, distortion, and figure-of-eight configurations were more frequent in non-survivors.
- No significant differences in maximum QRS and T vector magnitudes or maximum T angle were found.
Conclusions:
- Specific QRS loop abnormalities in the horizontal plane are associated with increased mortality in DCM.
- Posterior displacement, narrowness, distortion, or figure-of-eight configuration of the QRS loop in DCM suggests an unfavorable prognosis.