Евразийский Кардиологический Журнал (Sep 2018)

COMPARISON OF THE INTEGRAL INDICES OF THE VECTORCARDIOGRAM WITH CLINICAL DATA IN PATIENTS WITH CHRONIC CORONARY HEART DISEASE

  • T. A. Sakhnova,
  • E. V. Blinova,
  • Yu. V. Dotsenko,
  • E. S. Yurasova,
  • A. B. Sumarokov

DOI
https://doi.org/10.38109/2225-1685-2018-3-38-49
Journal volume & issue
Vol. 0, no. 3
pp. 38 – 49

Abstract

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The aim of the work was to compare the integral parameters of the vectorcardiogram (VCG) - spatial QRS-T angle and electrocardiographic ventricular gradient (VG) - with clinical data in patients with chronic coronary heart disease (CHD). The study included 213 patients with CHD (165 men and 48 women, mean age 62.1±9.8 years) who underwent a comprehensive clinical and instrumental examination. The control group consisted of 50 practically healthy persons (30 women and 20 men, mean age 56.5±8.8 years). The QRS-T angle and VG were calculated on the VCG, derived from the 12-lead digital ECG. In patients with CHD, the VG module and VG-X, VG-Y, VG-Z components were significantly smaller, and the QRS-T angle was significantly higher than in healthy individuals of the same sex. The presence of arterial hypertension, hyperlipidemia, diabetes mellitus, chronic heart failure and obesity was associated with increased QRS-T angle. In patients who had a history of anterior myocardial infarction, compared to patients without myocardial infarctions, the VG module and its components VG-X and VG-Z were significantly decreased and the QRS-T angle was increased. In patients who had a history of inferior-posterior myocardial infarction, the VG-Y component was significantly decreased and the VG-Z component was increased. The threshold value VG-Y<10 ms allowed to detect the old inferior-posterior myocardial infarction with a sensitivity of 63% and a specificity of 75%; threshold values of VG-X<14 ms and VG-Z<10 ms allowed to diagnose old anterior myocardial infarction with a sensitivity of 67-77% and specificity of 85-79%, respectively. In CHD patients, higher QRS-T angle values were associated with the presence of traditional risk factors - arterial hypertension, hyperlipidemia, diabetes and obesity. Changes in VG in myocardial infarctions of different localizations were different.

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