Vectorcardiographic Studies in Acquired Valvular Disease

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Abstract
A vectorcardiographic study using the Schmitt-Simonsen (SVEC-III) method was done in 92 patients with mitral and aortic acquired valvular disease in which left ventricular hypertrophy and the valvular lesions were proven by means of right and left heart catheterization, operation, or autopsy, or by all methods. Significant differences were found among groups with aortic insufficiency, aortic stenosis, and mitral insufficiency. The magnitude of the 0.01 and 0.02-sec and maximal spatial vectors and the voltages of the Q x , R x , as well as R z waves were greatest in the group with aortic insufficiency. The greatest voltages of the 0.03-sec and 0.04-sec vectors were found in patients with aortic stenosis. In this study the smaller voltages after the 0.03-sec vector were found in the group with mitral insufficiency, and these voltages were significantly increased when aortic insufficiency complicated the picture. Groups with aortic insufficiency and mitral insufficiency, or aortic stenosis or insufficiency and mitral stenosis showed abnormal inferior orientation of the middle and terminal forces, which were explained upon the basis of the concomitant right ventricular hypertrophy. The authors believe that with the aid of the corrected orthogonal system of Schmitt and Simonsen (SVEC-III) the clinician will be able not only to make a more accurate evaluation of left ventricular hypertrophy, but also in many instances will find considerable assistance in arriving at a specific clinical diagnosis.