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At least 1,009 records · Page 56Linked to original sources
PubMed2005

Differences in left ventricular long-axis function from mice to humans follow allometric scaling to ventricular size.

While the heart size maintains a constant proportion to body size, heart function parameters, such as heart rate and cardiac output, show a more complex scaling pattern. How these phenomena affect the long-axis left ventricular (LV) function is unknown. We studied 10 mice, 15 rats, 6 rabbits, 8 mongrel dogs and 38 human volunteers. Doppler tissue echocardiography data were postprocessed to reconstruct mitral annulus (MA) peak systolic velocity and displacement. The relationship between MA peak velocity, MA displacement and LV ejection time, and LV end-diastolic volume (and mass) were fit to an allometric (power-law) equation Y=kMbeta. LV mass varied from 0.062 to 255 g, while end-diastolic volume varied from 0.014 to 205 ml. beta values of the relation between LV ejection time and LV end-diastolic volume and mass were 0.247+/-0.017 and 0.267+/-0.018, respectively. beta values of the relationship between MA displacement and LV end-diastolic volume and mass were 0.358+/-0.047 and 0.390+/-0.051 (P<0.023 versus beta of LV ejection time). beta values of the relationship between MA peak systolic velocity and LV end-diastolic volume and mass were 0.096+/-0.012 and 0.100+/-0.013, respectively (P<0.0001 versus 0). Finally, beta values of the relationship between the long-to-short axis displacement ratio and LV end-diastolic volume and mass were 0.077+/-0.017 and 0.086+/-0.019 (P<0.0001 versus 0). We conclude that MA velocity, displacement, and long-to-short axis displacement ratio scale allometrically to heart size. This reduces the relative long-axis contribution to heart function in small mammals.

Animals↗
PubMed1991

A finite helical axis as a landmark for kinematic reference of the knee.

Reference coordinates based on the finite helical axis for flexion of the knee from 0 to 90 deg are proposed. Six degree-of-freedom tracking allows the use of such a helical axis as a kinematic landmark for knee motion representation. Data from five human subjects in vivo are presented as a path of finite helical axes for flexion of the knee from 20 to 80 deg. The finite helical axis rotates by an average of 11.4 deg, the centrode translates an average of 19.8 mm, and the total axial translation averages 0.1 mm during flexion from 20 to 80 deg. Error due to the transducer was measured on a fixed-pivot pendulum and found to be 1.0 deg and 1.9 mm rms for the helical axis orientation and position, respectively, and 0.1 mm for the axial translation. Reproducibility and soft tissue effects on the measurements were repeatable to 4.0 deg and 2.7 mm rms in orientation and position, respectively, and 0.1 mm for the axial translations. Soft tissue errors averaged 4.9 deg and 3.6 mm in position and orientation, and 0.3 mm in the axial translations.

Adult↗
PubMedDate not supplied

The dosimetry of a single "hockey stick" portal for treatment of tumors of the cranio-spinal axis.

Conventional treatment of tumors of the cranio-spinal axis portal usually involves multiple-field, moving junction treatments to avoid overlapping fields over the spinal cord. To avoid these problems, we irradiate the cranio-spinal axis using a single "hockey stick" portal and the 25-MV x-ray beam from a Varian Clinac-35 linear accelerator. Patients are positioned prone on the floor 229 cm from the radiation source and the collimators are rotated 45 degrees so the maximum diagonal dimension of the field 116 cm at 229 cm is coincident with the cranio-spinal axis. The head is alternately rotated to treat the right-hand side one day and the left-hand side the next day. Thermoluminescent dosimetry in an anatomical phantom reveals that, relative to the 100% dose delivered at 4-cm depth on the central axis of the blocked field, the midline posterior fossa dose is about 100%, with a maximum dose of about 105% to the extreme posterior portion of the skull. The midline neck dose is about 95% and the dose to the inferior portion of the spinal cord is about 105%. The doses to other critical organs are also presented.

Head and Neck Neoplasms↗
PubMed1999

Off-axis x-ray spectra: a comparison of Monte Carlo simulated and computed x-ray spectra with measured spectra.

The off-axis x-ray spectra from a constant potential x-ray generator were measured with a high purity germanium spectrometer cooled to liquid nitrogen temperature. The measured spectra were compared with off-axis x-ray spectra calculated using a code based on the semiempirical model developed by Tucker et al. and Monte Carlo simulated x-ray spectra using the EGS4 code system. In this study, both the Tucker model, and the EGS4 code system, were found to produce off-axis bremsstrahlung x-ray spectra which agreed well with the spectra measured at three emerging angles. In the measured and the EGS4 generated spectra the total K-characteristic peaks were in increasing order, as observed in the anode to cathode direction, whereas the Tucker model produced maximum total K-characteristic peaks at the 6 degrees anode side, and lesser amounts at the central axis and the 6 degrees cathode side. Large differences in the total K-characteristic lines is seen among the three different methods. The EGS4 code system was able to produce x-ray spectra for a combination of target materials.

Computer Simulation↗
PubMed1993

Regulation of mycobacterial growth by the hypothalamus-pituitary-adrenal axis: differential responses of Mycobacterium bovis BCG-resistant and -susceptible mice.

The role of the hypothalamus-pituitary-adrenal (HPA) axis in regulating the growth of Mycobacterium avium in Mycobacterium bovis BCG-resistant and -susceptible congenic mice was evaluated. Restraint was used to activate the HPA axis, which resulted in an increase in the level of corticosterone in the plasma. Activation of the HPA axis increased the susceptibility of BALB/c.Bcgs mice to the growth of M. avium. In contrast, the growth of M. avium was not altered in BALB/c.Bcgr mice as a result of HPA activation. Adrenalectomy abolished the effect of HPA activation on mycobacterial growth, as did treatment of the mice with a glucocorticoid receptor antagonist, RU 486. Activation of the HPA axis also resulted in the increased susceptibility of splenic macrophages from Bcgs mice but not from Bcgr mice to M. avium growth in vitro. The production of tumor necrosis factor alpha and of reactive nitrogen intermediates by splenic macrophages from both strains of mice was suppressed as a result of HPA activation. The implications of these findings for resistance controlled by Bcg and for susceptibility to mycobacterial growth are discussed.

Adrenalectomy↗
PubMed1989

Superior QRS axis in ventricular septal defect.

The relation between the superior orientation of the QRS axis and the anatomical site of the defect in the ventricular septum in patients with a ventricular septal defect was studied. Of 1031 patients with a ventricular septal defect, 64 (6.2%) had a superior axis on their electrocardiogram. In 59% of these patients the defect was in the inlet portion of the ventricular septum or affected this area. None of the cases was classified as an isolated ventricular septal defect of the persistent atrioventricular canal type. While there is an association between a superior axis and perimembranous inlet ventricular septal defect, a superior QRS axis does not characterise a ventricular septal defect as being of the atrioventricular canal type.

Echocardiography↗
PubMed1990

An association between left axis deviation and an aneurysmal defect in children with a perimembranous ventricular septal defect.

Conspicuous left axis deviation was found in two thirds (27 patients) of 44 children with a perimembranous ventricular septal defect, echocardiographic signs of apposition of the septal tricuspid valve leaflet, and an aneurysm of the membranous septum. In 10 patients earlier electrocardiograms did not show left axis deviation; this feature appeared when the aneurysm of the membranous septum was first seen on the echocardiogram. None of the 44 controls with perimembranous ventricular septal defect but without an aneurysm had left axis deviation. This study suggests that the appearances of conspicuous left axis deviation in a patient with ventricular septal defect indicate a spontaneous reduction in the defect by apposition of the septal tricuspid valve leaflet and by the formation of an aneurysm of the membranous septum.

Adolescent↗
PubMedDate not supplied

Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation.

Although celiac axis stenosis is a frequently encountered occlusive vascular disease, clinically significant ischemic bowel disease caused by celiac axis stenosis is rarely reported due to rich collateral circulation from the superior mesenteric artery (SMA). The most important and frequently encountered collateral vessels from the SMA in patients with celiac axis stenosis are the pancreaticoduodenal arcades and the dorsal pancreatic artery. Subtypes of collateral pathways via the dorsal pancreatic artery include a longitudinal pathway between the celiac branches and the SMA or its branches and a transverse pathway to either the splenic or gastroduodenal artery. A communicating channel between the right hepatic artery and the SMA can be a route for collateral circulation. Hepatic artery variants cause the development of unique collateral pathways that have different characteristics depending on the type of variant. These collateral pathways include intrahepatic interlobar collateral vessels, right gastric to left gastric arterial anastomoses, left hepatic to left gastric arterial anastomoses, and peribiliary arterial plexuses. Major collateral pathways in patients with celiac axis stenosis can be identified with spiral CT, and knowledge concerning this collateral circulation may be important for certain medical procedures such as interventional procedures for the management of hepatic tumors, pancreaticobiliary surgery, and liver transplantation.

Angiography↗
PubMed2005

Chest CT performed with z-axis modulation: scanning protocol and radiation dose.

Institutional review board approval of the study protocol and waiver of informed consent were obtained. This study was compliant with the Health Insurance Portability and Accountability Act. The purpose of this study was to retrospectively assess the scanning protocol and radiation dose associated with z-axis automatic tube current modulation in multi-detector row CT scanning of the chest. Fifty-three patients (mean age, 54 years; age range, 26-77 years; 25 men, 28 women) underwent 16-detector row chest CT with z-axis modulation and noise indexes of 10.0, 12.5, and 15.0 HU. Two radiologists independently compared images acquired with z-axis modulation and fixed tube current (180-300 mA) techniques for image noise, diagnostic acceptability, and depiction of peripheral bronchovascular markings. Tube current-time product was calculated for each study. There was good interobserver agreement between the two readers (kappa = 0.72). Compared with the fixed tube current technique, z-axis modulation provides acceptable image noise for chest CT, with an 18% and 26% reduction in tube current-time product at 10.0- and 12.5-HU noise indexes, respectively.

Adult↗
PubMed2000

Excess portal venous long-chain fatty acids induce syndrome X via HPA axis and sympathetic activation.

We tested the hypothesis that excessive portal venous supply of long-chain fatty acids to the liver contributes to the development of insulin resistance via activation of the hypothalamus-pituitary-adrenal axis (HPA axis) and sympathetic system. Rats received an intraportal infusion of the long-chain fatty acid oleate (150 nmol/min, 24 h), the medium-chain fatty acid caprylate, or the solvent. Corticosterone (Cort) and norepinephrine (NE) were measured as indexes for HPA axis and sympathetic activity, respectively. Insulin sensitivity was assessed by means of an intravenous glucose tolerance test (IVGTT). Oleate infusion induced increases in plasma Cort (Delta = 13.5 +/- 3.6 microg/dl; P < 0.05) and NE (Delta = 235 +/- 76 ng/l; P < 0.05), whereas caprylate and solvent had no effect. The area under the insulin response curve to the IVGTT was larger in the oleate-treated group than in the caprylate and solvent groups (area = 220 +/- 35 vs. 112 +/- 13 and 106 +/- 8, respectively, P < 0.05). The area under the glucose response curves was comparable [area = 121 +/- 13 (oleate) vs. 135 +/- 20 (caprylate) and 96 +/- 11 (solvent)]. The results are consistent with the concept that increased portal free fatty acid is involved in the induction of visceral obesity-related insulin resistance via activation of the HPA axis and sympathetic system.

Animals↗
PubMed1992

Effect of diet on glucose transporter site density along the intestinal crypt-villus axis.

High-carbohydrate diets stimulate intestinal brush-border glucose uptake and increase the number of glucose-protectable phlorizin binding sites, but it has been unknown where along the crypt-villus axis these effects are expressed. We attacked this problem by three methods. First, by measuring phlorizin binding to isolated mouse enterocytes fractionated along the crypt-villus axis by the Weiser method, we identified a high-affinity binding site predominating from villus tip to midvillus and a site of possibly lower affinity predominating in the crypts. A high-carbohydrate diet increased by severalfold the density of the villus sites and probably also of the crypt sites, without changing their binding constants. Second, autoradiography revealed increased glucose-protectable phlorizin binding along the whole crypt-villus axis on a high-carbohydrate diet. Finally, a polyclonal antibody against the Na(+)-glucose cotransporter recognized a protein in the brush-border membrane of villus cells. Hence, substrate-dependent upregulation of intestinal glucose transport involves increased numbers of transporters along the crypt-villus axis.

Analysis of Variance↗
PubMed2003

NaCl transport across the opercular epithelium of Fundulus heteroclitus is inhibited by an endothelin to NO, superoxide, and prostanoid signaling axis.

Recent evidence suggests that paracrine signaling agents, such as endothelin (ET), nitric oxide (NO), superoxide (O2-), and prostanoids can modulate mammalian renal function by affecting both hemodynamic and epithelial ionic transport pathways. Since these signaling pathways have been described in fish blood vessels, we hypothesized that they may control salt transport across the gill epithelium--the primary site of ion excretion in marine teleost fishes. We found that ET, the NO donors sodium nitroprusside and spermine NONOate, and the prostanoid PGE2 each can produce a concentration-dependent reduction in the short circuit current (Isc) across the isolated opercular epithelium of the killifish (Fundulus heteroclitus), the generally accepted model for the marine teleost gill epithelium. Sarafotoxin S6c was equipotent to ET-1, suggesting that ETB receptors are involved. Incubation with NG-nitro-L-arginine methyl ester (L-NAME) or indomethacin reduced the effect of subsequent addition of SRXS6c by 17 and 89%, respectively, suggesting the presence of an ET to NO and PGE axis. The effects of l-NAME and indomethacin were not additive, but the superoxide dismutase mimetic 4-hydroxy-2,2,6,6-tetramethylpiperidine 1-oxyl (TEMPOL) reduced the effect of SRXS6c by 34% and preincubation with l-NAME, indomethacin, and TEMPOL reduced the SRXS6c response to zero. This suggests a direct role for O2- in this axis. COX-2 appears to be the major enzyme involved in this axis because the specific COX-2 inhibitor NS-398 was twice as effective as the COX-1 inhibitor SC560 in inhibiting the SRXS6c effect. The Isc was stimulated by the EP2 agonist butaprost and inhibited by the EP(1,3) agonist sulprostone, suggesting both stimulatory and inhibitory PGE receptors in this tissue. Carbaprostacyclin (PGI2 analog), thromboxane A2, PGF(2alpha), and PGD2 did not affect the Isc. Our data are the first to suggest the importance of an ET-stimulated and NO-, O2(-)-, and PGE2-mediated signaling axis that can modify active extrusion of NaCl across the killifish opercular epithelium and, by inference, the marine teleost gill epithelium.

Animals↗
PubMed2003

Eye movements during multi-axis whole-body rotations.

The semi-circular canals and the otolith organs both contribute to gaze stabilization during head movement. We investigated how these sensory signals interact when they provide conflicting information about head orientation in space. Human subjects were reoriented 90 degrees in pitch or roll during long-duration, constant-velocity rotation about the earth-vertical axis while we measured three-dimensional eye movements. After the reorientation, the otoliths correctly indicated the static orientation of the subject with respect to gravity, while the semicircular canals provided a strong signal of rotation. This rotation signal from the canals could only be consistent with a static orientation with respect to gravity if the rotation-axis indicated by the canals was exactly parallel to gravity. This was not true, so a cue-conflict existed. These conflicting stimuli elicited motion sickness and a complex tumbling sensation. Strong horizontal, vertical, and/or torsional eye movements were also induced, allowing us to study the influence of the conflict between the otoliths and the canals on all three eye-movement components. We found a shortening of the horizontal and vertical time constants of the decay of nystagmus and a trend for an increase in peak velocity following reorientation. The dumping of the velocity storage occurred regardless of whether eye velocity along that axis was compensatory to the head rotation or not. We found a trend for the axis of eye velocity to reorient to make the head-velocity signal from the canals consistent with the head-orientation signal from the otoliths, but this reorientation was small and only observed when subjects were tilted to upright. Previous models of canal-otolith interaction could not fully account for our data, particularly the decreased time constant of the decay of nystagmus. We present a model with a mechanism that reduces the velocity-storage component in the presence of a strong cue-conflict. Our study, supported by other experiments, also indicates that static otolith signals exhibit considerably smaller effects on eye movements in humans than in monkeys.

Adult↗
PubMed2002

Compensatory and orienting eye movements induced by off-vertical axis rotation (OVAR) in monkeys.

Nystagmus induced by off-vertical axis rotation (OVAR) about a head yaw axis is composed of a yaw bias velocity and modulations in eye position and velocity as the head changes orientation relative to gravity. The bias velocity is dependent on the tilt of the rotational axis relative to gravity and angular head velocity. For axis tilts <15 degrees, bias velocities increased monotonically with increases in the magnitude of the projected gravity vector onto the horizontal plane of the head. For tilts of 15-90 degrees, bias velocity was independent of tilt angle, increasing linearly as a function of head velocity with gains of 0.7-0.8, up to the saturation level of velocity storage. Asymmetries in OVAR bias velocity and asymmetries in the dominant time constant of the angular vestibuloocular reflex (aVOR) covaried and both were reduced by administration of baclofen, a GABA(B) agonist. Modulations in pitch and roll eye positions were in phase with nose-down and side-down head positions, respectively. Changes in roll eye position were produced mainly by slow movements, whereas vertical eye position changes were characterized by slow eye movements and saccades. Oscillations in vertical and roll eye velocities led their respective position changes by approximately 90 degrees, close to an ideal differentiation, suggesting that these modulations were due to activation of the orienting component of the linear vestibuloocular reflex (lVOR). The beating field of the horizontal nystagmus shifted the eyes 6.3 degrees /g toward gravity in side down position, similar to the deviations observed during static roll tilt (7.0 degrees /g). This demonstrates that the eyes also orient to gravity in yaw. Phases of horizontal eye velocity clustered ~180 degrees relative to the modulation in beating field and were not simply differentiations of changes in eye position. Contributions of orientating and compensatory components of the lVOR to the modulation of eye position and velocity were modeled using three components: a novel direct otolith-oculomotor orientation, orientation-based velocity modulation, and changes in velocity storage time constants with head position re gravity. Time constants were obtained from optokinetic after-nystagmus, a direct representation of velocity storage. When the orienting lVOR was combined with models of the compensatory lVOR and velocity estimator from sequential otolith activation to generate the bias component, the model accurately predicted eye position and velocity in three dimensions. These data support the postulates that OVAR generates compensatory eye velocity through activation of velocity storage and that oscillatory components arise predominantly through lVOR orientation mechanisms.

Animals↗
PubMedDate not supplied

Immunoneuroendocrine connectivity: the paradigm of the thymus-hypothalamus/pituitary axis.

It is now largely established that the immune and neuroendocrine systems cross-talk by using similar ligands and receptors. In this context, the thymus-hypothalamus/pituitary axis can be regarded as a paradigm of connectivity in both normal and pathological conditions. For example, cytokines and thymic hormones modulate hypothalamic-pituitary functions: (a) interleukin (IL)-1 seems to upregulate the production of corticotropin-releasing factor and by adrenocorticotropin by hypothalamic neurons and pituitary cells, respectively; (b) thymulin enhances LH secretion. Conversely, a great deal of data strongly indicate that the hypothalamic-pituitary axis plays a role in the control of thymus physiology. Growth hormone (GH) for example, enhances thymulin secretion by thymic epithelial cells (TEC), both in vivo and in vitro, also increasing extracellular matrix-mediated TEC/thymocyte interactions. Additionally, gap junction-mediated cell coupling among TEC is upregulated by ACTH. In a second vein, it was shown that GH injections in aging mice increased total thymocyte numbers and the percentage of CD3-bearing cells, as well concanavalin-A mitogenic response and IL-6 production. In addition to mutual effects, thymus-pituitary similarities for cytokine and hormone production have been demonstrated. Cytokines such as IL-1, IL-2, IL-6, interferon-gamma, transforming growth factor-beta and others can be produced by hypothalamic and/or pituitary cells. Conversely, hormones including GH, PRL, LH, oxytocin, vasopressin and somatostatin can be produced intrathymically. Moreover, receptors for various cytokines and hormones are expressed in both the thymus and the hypothalamus/pituitary axis. Lastly, it is noteworthy that a thymus-pituitary connectivity can also be seen under pathological situations. In this regard, an altered HPA axis has been reported in AIDS, human falciparum malaria and murine rabies, that also show a severe thymic atrophy.

Animals↗
PubMed2000

Centrally administered murine-leptin stimulates the hypothalamus-pituitary- adrenal axis through arginine-vasopressin.

Starvation induces a decrease in circulating leptin levels and activation of the hypothalamus-pituitary-adrenal (HPA) axis. Leptin inhibits the HPA axis in unfed rodents or genetically leptin-deficient ob/ob mice, whereas it stimulates corticotropin-releasing hormone (CRH) gene expression in the paraventricular nucleus (PVN). However, the interactions between leptin, CRH and the HPA axis are poorly understood and are likely to be complex. We recently demonstrated that central leptin administration caused increases in plasma arginine-vasopressin (AVP) and AVP gene expression of the PVN in nonstressful rats. AVP stimulates the release of adrenocorticotropic hormone (ACTH), but it also potentiates the action of CRH on ACTH release. In this study, we investigated the effects of leptin on plasma ACTH and corticosterone levels, CRH mRNA of the PVN and proopiomelanocortin (POMC) mRNA of the pituitary in nonstrained rats. Intracerebroventricularly administered leptin caused increases in plasma ACTH and corticosterone levels in dose-dependent manners. In Northern blot analyses, the leptin injection induced significant increases in the expression of CRH mRNA in the PVN and POMC mRNA in the pituitary. The increased plasma ACTH and corticosterone levels by leptin were attenuated with intracerebroventricular pretreatment of a V(1a) receptor antagonist (OPC-21268) or a V(1a)/V(1b) receptor antagonist (dP[Tyr(Me)(2)]AVP), but not with that of a V(2) receptor antagonist (OPC-31260). The leptin-induced CRH mRNA expression in the PVN and POMC mRNA expression in the pituitary were also reduced by the pretreatment with OPC-21268 and dP[Tyr(Me)(2)]AVP. These results suggest that intracerebroventricular leptin administration activates the HPA axis by AVP receptor activation through V(1a) receptors in the PVN which in turn activates CRH neurons to drive ACTH and corticosterone secretion in concert with AVP in nonstrained rats.

Adrenocorticotropic Hormone↗
PubMed2003

Impact of cancer therapy on the reproductive axis.

Cancer therapy includes surgery, chemotherapy and irradiation. Depending on the diagnosis, the location of the neoplasm and the age of the patient, these treatment modalities may be given alone or in combination. All forms of cancer therapy can affect the hypothalamic-pituitary-gonadal axis. The long-term consequences for reproductive function depend on several aspects. The sex of the patient is important, since ovarian and testicular function differ significantly. Sex hormone production in the female is dependent on the presence of germ cells, whereas this is not the case in the male. The sensitivity of germ cells to cancer therapy also differs between the sexes. Moreover, the sensitivity of both the hypothalamic-pituitary axis and the gonads is highly age dependent. With regard to chemotherapy, the possible damage to the gonads is dependent on the total dose and type of agent given. According to current knowledge, the hypothalamic-pituitary axis is not affected by conventional doses of chemotherapy. Radiotherapy has by far the most damaging effect on the reproductive axis, having serious adverse effects on both the hypothalamic-pituitary area as well as on the gonads themselves. The harmful effect of irradiation depends on the total dose of irradiation, the radiation field, as well as the number and size of fractions given. The long-term consequences of recently introduced radiotherapeutic methods such as stereotactic irradiation are not yet known. The present review will focus on the late effects of cancer therapy in children and young adults with acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, brain tumour, Hodgkin's lymphoma or Wilms' tumour, including the adverse effects of bone marrow transplantation.

Adolescent↗
PubMed2004

The electrical T-axis and the spatial QRS-T angle are independent predictors of long-term mortality in patients admitted with acute ischemic chest pain.

OBJECTIVE: To investigate whether the orientation of the electrical T-axis and the spatial QRS-T angle provide independent diagnostic and prognostic information in patients presenting with acute chest pain. METHODS: Patients with symptoms suggestive of acute cardiac pathology, who were seen by a general practitioner and for whom a prehospital electrocardiogram (ECG) was recorded by the ambulance service between 1992 and 1994 were investigated. The ECGs (n = 2,261) for our study population were stored for off-line analysis by the Modular ECG Analysis System. QRS- and T-axes were computed from the reconstructed vectorcardiographic X, Y and Z leads. During the year 2000, a follow-up of the entire cohort was performed, and the vital status of the patients was determined via the civil registrar's office. Cox multivariable regression analyses were performed to evaluate the relation between the orientation of the T-axis, the spatial QRS-T angle and long-term mortality. RESULTS: An abnormal orientation of the T-axis and the spatial QRS-T angle were associated with an increased likelihood of cardiac diseases and an increased risk of all-cause mortality during short- and long-term follow-up. CONCLUSIONS: We conclude that the frontal T-axis and the spatial QRS-T angle are important determinants of diagnosis and prognosis in patients presenting with acute chest pain. The reintroduction of vectorcardiography in routine clinical practice might therefore be reconsidered.

Aged↗