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Vectorcardiograms in dilated cardiomyopathy and triple vessel coronary artery disease: a comparative study by
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Vectorcardiography reveals that ventricular gradients and QRS deflection areas correlate with impaired left ventricular function in dilated cardiomyopathy (DCM) and coronary artery disease (CAD). The Aqrs-At Angle effectively detects myocardial damage severity.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Dilated cardiomyopathy (DCM) and coronary artery disease (CAD) significantly impair left ventricular function.
- Accurate assessment of myocardial damage is crucial for patient management.
Purpose of the Study:
- To investigate the relationship between vectorcardiographic parameters and left ventricular function in patients with DCM and CAD.
- To identify specific vectorcardiographic markers indicative of myocardial damage severity.
Main Methods:
- Analysis of vectorcardiography and left ventriculography in 40 patients (17 DCM, 14 CAD, 9 controls).
- Evaluation of QRS deflection area vector (Aqrs), ventricular gradients (G), G/Aqrs ratio, and Aqrs-At Angle.
- Correlation analysis with left ventricular ejection fraction (EF).
Main Results:
- Posteriorly directed Aqrs was most prominent in DCM, followed by CAD.
- Smaller and more posteriorly directed G was observed in DCM and CAD groups compared to controls.
- G/Aqrs and Aqrs-At Angle showed significant differences between patient groups and controls.
- Aqrs-At Angle demonstrated a strong negative correlation with left ventricular ejection fraction (r = -0.855).
Conclusions:
- Ventricular gradients, G/Aqrs, and Aqrs-At Angle are related to impaired left ventricular function in DCM and CAD.
- Aqrs-At Angle is a valuable parameter for assessing the grade of myocardial damage in both DCM and CAD.
Abstract:
An analysis using vectorcardiography and left ventriculography was made on forty patients, 17 of whom had dilated cardiomyopathy (DCM), 14 with triple vessel coronary artery disease (CAD) and 9 control subjects. QRS deflection area vector (Aqrs) was directed the most posteriorly in the DCM group and the second most posteriorly in the CAD group. Ventricular gradients (G) were smaller in the DCM and CAD groups than in the control group and directed more posteriorly in the DCM group than in the CAD and control groups. G/Aqrs was the smallest in the DCM group and the second smallest in the CAD group. Aqrs-At Angle was the widest in the DCM group and the second widest in the CAD group. Left ventricular ejection fraction (EF) showed high correlations with the azimuth of Aqrs (r = 0.659), with the magnitude of G (r = 0.720), with G/Aqrs (r = 0.785) and with Aqrs-At Angle (r = -0.855). From this evidence, we conclude that the magnitude of G, G/Aqrs and Aqrs-At Angle have a definable relationship with the impairment of left ventricular function and the Aqrs-At Angle is an especially useful parameter to detect the grade of myocardial damage in both the DCM and CAD groups.