Vectorcardiographic evolution of left ventricular hypertrophy.

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Abstract
Of 2800 vectorcardiograms (vcg), 23 had abnormal vector loop rotation in all 3 planes associated with evidence of incomplete left bundle-branch block and left ventricular hypertrophy. All 23 were patients with severe aortic valvular disease with no evidence of associated myocardial infarction. This is 8% of 300 patients studied with aortic disease. In 4 the gradual development of abnormal rotation in all 3 vector planes was demonstrated on serial vcg as the aortic disease became more severe. The configuration of the vector loops evolved through 5 developmental stages that correlated with the hemodynamic severity of the aortic lesion in these individual cases, but there was no correlation in the group as a whole. In 5 there was a rapid return to normal vector loop rotation in all 3 planes following corrective aortic valve operation. The scalar tracings also showed a rapid return toward normal. The rapidity of these changes suggests that both the abnormal direction of depolarization and some of the evidence of left ventricular hypertrophy were due to conduction disturbance.