Corrected (Frank), uncorrected (cube), and standard electrocardiographic lead systems in recording augmented right ventricular forces in right ventricular hypertension.

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Abstract
The results of the standard electrocardiogram, cube vectorcardiogram, and the corrected vectorcardiogram derived by the Frank system, in 50 patients with valvar pulmonary stenosis were compared with hemodynamic data obtained at cardiac catheterization. Right ventricular hypertension at rest was found to range from 40 to 196 mm Hgl. Right ventricular peak pressue, right ventricular work, and pulmonary valve area were used as objective criteri for comparison. Two new vectorcardiograph-ic parameters (MRSV and SMRSV) were derived, based on the measurement of the maximum rightward directed spatial force. Standard electrocardiographic criteria were employed. A significant correlation between right ventrical peak pressure and the maximum rightward spatial vector (r =0.87) and a sum of maximum rightward vectors (r=0.90) was found, using data derived from the Frank system. Similar correlations for the cube system were less significant (r =0.82 and 0.83), while all correlations with ventricular work were insignificant. These results indicate the superiority of the orthogonal corrected lead system of Frank in these electrocardiographic-hemodynamic correlations. The progressively changing configuration of spatial forces with increasing severity of hypertension gives further insight into the alterations in the depolarization process in right ventricular hypertrophy. These findings also prove that, with new criteria employing the measurement of truly spatial magnitudes, reliable estimation of resting right ventricular pressure may be obtained.