Does vectorcardiography improve the prediction of left ventricular hypertension compared to standard electrocardiography in patients with congenital aortic stenosis?
Vectorcardiograms offer better prediction of left ventricular hypertension than standard ECGs in congenital aortic stenosis, though both remain inferior to invasive cardiac catheterization.
In a previous study (Hugenholtz, Lees, and Nadas, 1962) correlations between the resting hemodynamic state in congenital aortic stenosis (AS) and the cube vectorcardiogram showed great accuracy in predicting the presence of left ventricular hypertension. Results were better than those obtained by the standard electrocardiogram in a study of a larger group of similar patients (Braun- wald et al., 1963). Furthermore, alterations in the direction and magnitude of specific QRS vectors, as projected on the horizontal plane, correlated to some degree with left ventricular peak pressure and aortic gradient. However, the wide variation in these measurements often made proper assessment of the individual case impossible. Thus, while distinctly better than the standard electrocardiogram in the recognition of left ventricular hypertension, this type of uncorrected vectorcardiographic recording still proved to be inferior to the assessment of severity obtained by means of cardiac catheterization.
Gamboa et al. (Sat,) studied this question.
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