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At least 721 records · Page 40Linked to original sources
PubMed1984

Pulmonary hypertension and respiratory failure in the development of right ventricular hypertrophy in patients with chronic obstructive airway disease.

The high incidence of right ventricular hypertrophy in patients with chronic obstructive pulmonary disease is a well-known fact. In clinical medicine according to our present status of thinking, severe impairment of ventilatory function and pulmonary hypertension are the two essential prerequisites for right ventricular involvement. To investigate this accepted assumption we studied 51 patients with chronic obstructive pulmonary disease, while they were in a remission period. The patients were subjected to clinical examination, chest roentgenography, spirometry, blood gas examination, electrocardiography, vectorcardiography, echocardiography, and right heart catheterization. The majority of the patients with significantly compromised ventilatory function and abnormal blood gases had right ventricular hypertrophy with elevation of the pulmonary artery pressure. Two subgroups of patients could be distinguished: One included 15 patients (29.4% of all patients) with normal pulmonary artery pressure and evidence of right ventricular hypertrophy. In this subgroup are included 10 patients (19.6% of all patients) showing mild ventilatory impairment and mild hypoxaemia. The second subgroup consisted of 5 patients (9.8% of all patients) with elevated mean pulmonary artery pressure at rest and right ventricular hypertrophy showing relatively mild ventilatory impairment and moderate hypoxaemia. Two conclusions could be drawn: (1) the pulmonary artery pressure at rest could be normal despite the evidence of right ventricular hypertrophy, and (2) a mild ventilatory impairment does not exclude an elevated pulmonary artery pressure or the development of right ventricular hypertrophy in patients with chronic obstructive pulmonary disease.

Aged↗
PubMed1968

Correlation of vectorcardiogram and electrocardiogram with coronary arteriogram.

One hundred patients with suspected coronary heart disease were studied by vectorcardiography (VCG), electrocardiography (ECG), and coronary arteriography. Twenty-eight patients had VCG evidence of anterior infarction; 26 of this group had severe narrowing or obstruction of the left anterior descending branch. Five did not have anterior infarction by ECG. Twenty-seven patients had VCG evidence of diaphragmatic infarction; 25 of this group had severe narrowing of the right coronary artery or the left circumflex branch or both. Six of the 27 did not have ECG evidence of diaphragmatic infarction. Twelve patients had VCG evidence of posterior infarction whereas it was detected by ECG in only two. Only six of the 12, however, had severe narrowing of the nutrient arteries to the posterobasal part of the myocardium. Thirteen patients with infarction had severe narrowing but not total obstruction of a coronary artery. On the other hand, 15 patients had total obstruction of a major coronary vessel without actual infarction.

Adult↗
PubMed1978

Differentiation of posterior myocardial infarction from right ventricular hypertrophy and normal anterior loop by echocardiography.

The differentiation of posterobasal myocardial infarction (PMI) from either right ventricular hypertrophy (RVH) or normal subjects displaying an anterior loop (AL) by electrocardiography (ECG) or vectorcardiography (VCG) is difficult. M-mode echocardiography (echo) via the anterior and subxiphoid methods has been helpful in defining cardiac chamber size and wall motion abnormalities. We tested whether this relatively more direct method would better separate these entities compared with the other two techniques. ECG and VCG using established criteria failed to distinguish the three conditions effectively. By echo, distinguishing characteristics were observed in each of the groups. Thus, right ventricular diastolic dimension and wall thickness were significantly increased only in the RVH group, echo dimensions and wall motion were normal in the AL group and the posterior left ventricular systolic thickening response and ejection phase indices were significantly reduced only by the subxiphoid method in the PMI group. To test the specificity of the latter finding, posterior wall motion in three infarction groups (posterior, combined posteroinferior and inferior) were examined and suggested that the target of the subxiphoid beam focuses on a more superior posterobasal left ventricular segment than the anteriorly placed transducer. Echocardiography can differentiate PMI from either RVH or AL more directly than ECG or VCG, and may be of practical clinical importance.

Adult↗
PubMed1981

Thallium myocardial perfusion scans for the assessment of right ventricular hypertrophy in patients with cystic fibrosis. A comparison with other noninvasive techniques.

The incidence of right ventricular hypertrophy in 32 patients with cystic fibrosis was studied using thallium 201 (TI-201) myocardial perfusion scans, and compared with other noninvasive techniques including electrocardiography, vectorcardiography, and M-mode echocardiography. The patients (mean age, 17.3 yr; range, 7 to 33) had a wide range of clinical and pulmonary abnormalities (mean Shwachman-Kulczycki score, 66.6). In the total study group, TI-201 scans, like the vectorcardiograms and the M-mode echocardiograms, gave a surprisingly high proportion of positive predictions for right ventricular hypertrophy (RVH) (44%). The correlations with all other noninvasive methods were uniformly poor, so caution must be exercised in using this technique to predict early RVH in order to follow the natural history of cor pulmonale in cystic fibrosis. At the time of the study, 6 patients had clinical evidence of right ventricular failure, and in this disease setting must have had RVH. In 3 patients, RVH was confirmed at autopsy, and it was successfully predicted by TI-201 scans in 5 of the 6 patients. The false negative scan may have been due to regional myocardial ischemia secondary to severe right ventricular failure. In contrast, the vectorcardiogram, using Fowler's new criteria, made a successful prediction of RVH in all 6 patients, and the electro cardiogram in only 3. Although the M-mode echocardiogram was abnormal in all patients, it would have predicted RVH (with increased right ventricular anterior wall thickness) in only 1 patient. We concluded that TI-201 myocardial perfusion cans are good at confirming RVH in cases with established right ventricular failure, but have no advantage over vectorcardiographic assessments, which are logistically easier to perform and carry no radiation risks.

Adolescent↗
PubMed1981

Spatial electrocardiography.

Spatial electrocardiography can express the spatial characteristics of electromotive forces of the heart quantiatively. The pattern of the sequential changes of these spatial characteristics of the cardiac vectors also provides important diagnostic informations. Accordingly, spatial electrocardiography is considered to be useful in clinical cardiology in association with conventional electrocardiography and vectorcardiography.

Humans↗
PubMed1982

Clinical significance of ventricular gradient with a right orientation.

In 1,000 patients on whom vectorcardiography was performed, ventricular gradients (G) were calculated using a micro-computer. In 73 patients, excluding those with dextrocardia and atrial fibrillation, the X component of the ventricular gradient (Gx) showed a negative value. These patients with a negative Gx were divided into the following 10 subgroups and their G were compared: hypertrophic non-obstructive cardiomyopathy (HCM), hypertrophic obstructive cardiomyopathy (HOCM), congestive cardiomyopathy, concentric left ventricular hypertrophy, aortic valvular disease, ischemic heart disease, myocardial infarction, pericarditis, right ventricular hypertrophy and others. The HCM group was the most characteristic with large Aqrs oriented to the left, the largest At oriented to the right and the largest G oriented to the right. Gx in this group showed values more negative than -50 micro V . sec (-92.2 +/- 32.0) and significantly differed from other groups.

Adolescent↗
PubMed1984

Relationship between ventricular gradient and the impairment of wall motion of the left ventricle in coronary artery disease.

Fifty patients with or without coronary artery disease were studied. Twelve of them showed no coronary artery obstruction, while 38 demonstrated obstruction of the left anterior descending artery (LAD). Of the latter 38, 16 had obstruction at LAD alone, 6 at LAD and right coronary artery (RCA), 8 at LAD and left circumflex artery (LCx) and 8 at LAD, RCA and LCx. Vectorcardiography, selective coronary cineangiography and left ventricular cineangiography were undertaken in all subjects. The vectorcardiogram (VCG) was recorded on a magnetic tape and QRS area vector (Aqrs), T area vector (At) and ventricular gradient (G) were calculated by micro-computer. From left ventriculogram (LVG) "score" was computed to express the grade of impairment of the wall motion. Correlations between various vector-cardiographic parameters and this score were examined. The score correlated significantly (p less than 0.001) with azimuth of Aqrs (r = -0.545), azimuth of At (r = 0.661), magnitude of G (r = -0.705), azimuth of G (r = 0.533), G/Aqrs (r = -0.645), spatial angles between Aqrs and At (r = 0.591) and between max R and max T (r = 0.595) and X component of G (r = -0.758). These results suggested the usefulness of ventricular gradient to grasp the grade of coronary artery disease.

Cineangiography↗
PubMed1985

Vectorcardiograms in dilated cardiomyopathy and triple vessel coronary artery disease: a comparative study by ventricular gradient.

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.

Adult↗
PubMed1991

Comparative study of five preoperative methods for the localization of accessory pathways in the Wolff-Parkinson-White syndrome.

One hundred and thirty-four cases of Wolff-Parkinson-White syndrome were studied to evaluate the relative usefulness of electrocardiography (ECG), electrophysiological studies (EPS), body surface mapping (BSM), gated blood-pool phase analysis (nuclear studies), and vectorcardiography (VCG) in the localization of the accessory pathway (ACP). In comparison with the final localization verified by intraoperative studies, 93.4% in 8-region ACP localization (97.7% in 4-region ACP localization) could be correctly localized by ECG using our criteria, 83.9% (86.8%) by EPS, 82.6% (95.8%) by BSM, 78.8% (87.7%) by nuclear studies, and 67.3% (78.0%) by VCG. It was concluded that: (a) ACP can be localized preoperatively with considerable accuracy by using our simple ECG criteria. (b) The EPS method has some limitation, especially with respect to 8-region ACP localization. (c) Our observation showed no evidence that BSM, VCG, or nuclear studies were superior to ECG in ACP localization. (d) Among the 5 methods studied, ECG and EPS appear to be the appropriate procedures for preoperative ACP identification.

Adolescent↗
PubMed1993

Spatial orientation of the vectorcardiogram in patients with myocardial infarction.

We studied the rotation angles on the each of 3 axes and the planarity and roundness of QRS loop when its plane was laid close to horizontal in 4 groups of patients. Thirty five had anterior myocardial infarction, 34 inferior infarction, 15 non Q wave inferior infarction, and 34 were normal subjects. The rotation angles of the QRS loop were significantly different from the controls, on the Y and Z axes in the anterior infarction group, on the Z axis in the inferior infarction group and on the X axis in the non Q wave inferior infarction group (p < 0.01). The planarity index in the inferior infarction group was significantly higher (p < 0.01) than in other groups. The significantly smallest value of the roundness index was noted in the anterior infarction group (p < 0.01). Significant features of the early segmental planarity indexes were shown in the non Q and Q wave inferior infarction groups (p < 0.01). We conclude that the rotation angles and the planarity and roundness indexes are characteristic parameters for the infarct group and may be useful for diagnosing myocardial infarction, which is difficult with electrocardiography and vectorcardiography.

Adult↗
PubMed1986

Vectorcardiographic and blood pressure correlates of obstructive pulmonary diseases in a community population.

Vectorcardiography was performed on 2,449 subjects, aged six years and older, in the Tucson (Ariz) Epidemiological Study of Airway Obstructive Diseases (AOD), 95 percent of the white non-Mexican Americans in the stratified cluster population sample. The objectives were to confirm previous relationships and to determine if hypothesized changes in the vectorcardiogram (VCG) could predict AOD. Trained nurse technicians performed the VCGs, which were read and interpreted by a cardiologist. Vectorcardiographic results were broadly interpreted for abnormalities. Also, calculated vector means and angles were compared to standard questionnaire responses for medical history, to maximum expiratory flow-volume variables, and to values for blood pressure; these were all corrected for sex, age, height, weight, and the ponderal index. Values were expressed as percentages of predicted. Over 80 percent of the VCGs were found to be normal. Measured hypertrophy was related to disease; there were significantly more abnormalities in those with histories of heart disease, hypertension, arteriosclerosis, and AOD, when examined by types of ventricular hypertrophy and VCG-identified heart disease or hypertension; findings of AOD and heart disease were also correlated significantly. Of all the ventricular hypertrophy, right ventricular hypertrophy (RVH), type C, was confirmed to be the predominant type associated with decreased pulmonary function in all smoking groups. Systolic blood pressure was related to RVH, type A, and diastolic 4 and 5 blood pressure with RVH, types A and B. The vectors' magnitude and angles were related to abnormality of pulmonary function in those with and without heart disease and AOD.

Adolescent↗
PubMed2002

Isolated ultrafiltration affects dynamic vectorcardiographic ischemia monitoring parameters.

AIMS: The present study was undertaken to assess the role of isolated ultrafiltration (UF phase) and hemodialysis with minimal ultrafiltration (HD phase) in changes in parameters reflecting myocardial ischemia: QRS vector difference (QRS-VD), ST change vector magnitude (STC-VM) and ST vector magnitude (ST-VM6) registered by MIDA (myocardial infarction dynamic analysis). PATIENTS AND METHODS: Twelve patients on maintenance hemodialysis were first ultrafiltrated for 2.5 h without dialysis (UF) followed by a 2.5-hour session of hemodialysis with minimal ultrafiltration (HD). Computerized vectorcardiography (VCG) was used for on-line dynamic analysis of ST segment and QRS complex changes. Blood volume (BV) changes were monitored non-invasively and continuously with the CRIT-LINE instrument. Whole-body bioelectric impedance analysis (BIA) was used for extracellular water (ECW) estimation. RESULTS: During the UF phase QRS-VD and STC-VM showed a statistically significant increasing linear trend (time effect for both QRS-VD and STC-VM p < 0.0001, while no changes were noted in ST-VM6; time effect p = 0.986). During the HD phase none of these parameters changed (time effect for QRS-VD p = 0.855, for STC-VM p = 0.275 and for ST-VM6 p = 0.976). During the UF, phase changes in QRS-VD were in close relation to those in ECW. CONCLUSION: Isolated ultrafiltration leads to an increase in the VCG ischemia monitoring parameters QRS-VD and STC-VM. The increase of QRS-VD is related to changes in ECW. Hemodialysis with minimal ultrafiltration has no effect on VCG ischemia monitoring parameters.

Adult↗
PubMed1976

[Changes in the vectorcardiogram in rheumatism with coronary vessel lesions].

Changes in vectorcardiograms (VCG) taken in 5 projections by the I.T. Akulinichev technique were studied in 101 patients with rheumatic fever involving the coronaries. The VCG changes were found not to be specific of rheumatic coronaritis, but to reflect the degree of coronary insufficiency and myocardial hypoxia in general. In coronaritis with myocardial infarction VCG displayed asynchronism and the QRS complex deformities, their unlocked pattern, and a decrease in the T wave amplitude. When myocardial infarction of a rheumatic genesis developed, signs of focal myocardial lesion appeared on the VCG similar to those observed in cases of ischaemic heart disease. Vectorcardiography was concluded to significantly supplement the capacity of electrocardiography in revealing coronarites.

Adolescent↗
PubMed1976

[Experience with combined use of neurolepsy and vasodilator substances in the treatment of patients with acute myocardial infarct].

On the basis of an examination of 412 patients with myocardial infarction the efficacy of a long-term employment (for 3--4 days) of a neuroleptic Droperidol and a vasodilator Curantyl was examined. Optimum dosages of the drug and its administration techniques were worked out with due account of the data of clinical and physiological observations and blood concentrations of Curantyl. The incidence of the pain syndrome, of extrasystolic arrhythmias, of cardiogenic shock and sudden ventricular fibrillation was shown to decrease under the effect of the treatment. Without affecting the haemodynamics of the general circulation, the employed combination of drugs improved the pulmonary circulation and produced a beneficial inotropic effect upon the right ventricular myocardium, thus causing a distinct improvement of microcirculation, normalizing the ratio of diameters of the arterioles and venules, increasing the level of the tissue blood flow, and significantly reducing the intravascular aggregation of the formed elements of the blood. A long-term combined employment of the drugs for a few early days of the disease clearly favoured a positive haemodynamics in an important part of the patients, as demonstrated by the data of electro- and vectorcardiography.

Acute Disease↗
PubMed1976

[The vectorcardiogram of Fallot's tetralogy in the first two years of life. Qualitative and quantitative analysis (author's transl)].

36 patients, less than two years old, affected by Fallot's tetralogy were studied by vectorcardiography. The configuration of the QRS loop in the three orthogonal planes, the voltage of the 0.10 sec spatial vector, RMSV and LMSV vectors, and their azimuth and elevation were evaluated. Such data have been correlated to arterial oxygen saturation. Qualitative analysis showed a clockwise or figure eight QRS loop on the H and F planes in the great majority of cases; and only in a counterclockwise loop on the H plane was the suspicion of an arterial oxygen saturation greater than 85% especially in cases older than two months. The terminal forces of the QRS loop on the H plane were always directed under the O point, Whereas in the valvular pulmonary stenosis, terminal forces are generally superior to the O point. Quantitative analysis demonstrated the constant increase of the RMSV and the direct relationship of the LMSV to arterial oxygen saturation, and so it was the principal parameter for evaluation of the left ventricular volume and the size of pulmonary flow and the degree of pulmonary stenosis. The relationship between the azimuth of 0.01 sec spatial vector to O2 saturation was highly significant, showing a progressive anterior development of the former, as the latter increased.

Age Factors↗
PubMed2000

Hemodialysis causes changes in dynamic vectorcardiographic ischemia monitoring parameters.

AIMS: The aim of this study was to establish whether changes in parameters reflecting myocardial ischemia QRS vector difference (QRS-VD), ST change vector magnitude (STC-VM) and ST vector magnitude (ST-VM6) during hemodialysis (HD) registered by MIDA (myocardial infarction dynamic analysis) are related to changes in blood volume (BV), extracellular water (ECW) and blood biochemistry. PATIENTS AND METHODS: Fifteen hemodialysis (HD) patients were studied. Computerized vectorcardiography was used for on-line dynamic analysis of ST segment and QRS complex changes. BV changes were monitored non-invasively and continuously with the CRIT-LINE instrument. Bioelectric impedance analysis (BIA) was used for ECW estimation. Blood samples were taken before and after hemodialysis for hemoglobin (B-Hb), hematocrit (B-Hcr), sodium (P-Na), chloride (P-Cl), magnesium (P-Mg), potassium (P-K), ionized calcium (P-iCa), phosphate (P-Pi) and astrup measurement. RESULTS: During dialysis treatment QRS-VD, ST-VM6 and STC-VM did not change in parallel. According to the linear mixed model, no statistically significant changes were noted in ST-VM6 during dialysis (time effect p = 0.5635). On the other hand, QRS-VD and STC-VM showed a statistically significant linear trend (time effect for QRS-VD p = 0.0001 and for STC-VM p = 0.0004). Changes in both ECW and BV affected the change in QRS-VD and in STC-VM. CONCLUSION: During HD treatment changes in the vectorcardiographic ischemia monitoring parameters QRS-VD and STC-VM are mostly related to ECW and BV changes and may give a false positive impression of myocardial ischemia. The ST-VM6 trend is less markedly influenced by volume changes.

Adult↗
PubMed1999

Vectorcardiographic evaluation of myocardial infarct size: comparisons with thallium myocardial scintigraphy.

OBJECTIVE: To determine the usefulness of vectorcardiography (VCG) in assessing myocardial infarct size. METHODS: The correlation of spatial and scalar parameters of VCG with the percent defect volume (%DV) of thallium myocardial single photon emission computed tomography (SPECT) was investigated in 63 patients with first-onset myocardial infarction (MI). VCG parameters included: (1) spatial parameters: magnitude, azimuth and elevation of the maximal vector, vectors at 20 ms and 30 ms, and (2) scalar parameters: amplitudes of 20 ms and 30 ms vectors at X, Y, and Z scalar leads abbreviated as X20, Y20, Z20, X30, Y30 and Z30, respectively. RESULTS: For anteroseptal MI, the azimuth of 30 ms vector and Z20 showed a significant correlation with %DV (r = 0.572, P < 0.05 and r = 0.832, P < 0.001) while in anteroseptal MI with involvement of lateral wall, the azimuth of 30 ms vector and X30 were correlated with %DV significantly (r = 0.775, and r = 0.780, P < 0.01). For inferior and inferoposterior MI, the elevation of 30 ms vector and Y30 were correlated well with %DV (r = 0.871, P < 0.01, r = 0.928, P < 0.001 for inferior MI and r = 0.678, P < 0.01, r = 0.760, P < 0.001 for inferoposterior MI). CONCLUSION: VCG parameters, especially scalar parameters, can be used to evaluate myocardial infarct size easily and non-invasively with remarkable accuracy.

Aged↗