直交誘導スカラ-心電図による左室肥大の診断
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The criteria which have been proposed by various authors for electrocardiographic diagnosis of left ventricular hypertrophy have common difficulties of considerably high percentage of false positive and negative cases. This may be ascribed to insufficient statistical consideration in settling the critical values for left ventricular hypertrophy and independent use of individual electrocardiographic findings. Because electrocardiographic pattern of left ventricular hypertrophy is regarded as a reflection of imbalance between the left and right ventricles, bipolar leads must be more useful than unipolar for this purpose. Routine 12 leads, however, do not include bipolar leads which reflect anteroposterior component of spatial vector loops. In this respect, the author used orthogonal electrocardiogram. Materials and Methods Orthogonal scalar leads were recorded by the Frank's lead system in 52 patients (32 males and 20 females, age ranged from 34 to 70 years) with sustained hypertension and 20 patients (11 males and 9 females, age ranged from 36 to 70 years) with aortic insufficiency. The cases showing bundle branch block were excluded from the subjects. Chest electrodes were placed in the fourth intercostal space as recommended by LANGER and others for patients in the supine position. The polarities of leads were determined so as to produce the positive deflection in lead X by leftward component of vectors, in lead Y by downward, and in lead Z by forward. As normal subjects, 56 persons (47 males, and 9 females, age ranged from 20 to 68 years), without clinical evidence of heart diseases and other conditions likely to influence on the electrocardiogram, were used. Results Comparing several electrocardiographic measurements between hypertensive and normal subjects, amplitude of Rx and Sz and duration of QRS were observed to be significantly greater in the former, and amplitude of Ry, Rz, Tx and Ty were larger in the latter (p<0.001). In aortic insufficiency amplitude of Rx and duration of QRS were significantly greater and amplitudes of Tx and Ty were smaller than those in normal subjects (p<0.001). There was no significant difference in any measurements between hypertension and aortic insufficiency.
- 社団法人日本循環器学会の論文
- 1968-07-20
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