Computer analysis of the orthogonal electrocardiogram and vectorcardiogram in 257 patients with aortic valve disease.
In most electrocardiographic studies of left ventricular hypertrophy the hypertrophy has had different causes. This study examined the performance of the Frank orthogonal electrocardiogram in 257 patients with aortic valve disease, 90 with predominant aortic stenosis and the remaining 167 with predominant aortic insufficiency. Optimal measurements suggested for routine electrocardiographic diagnosis of left ventricular overload resulted in recognition of 64 percent of cases of aortic stenosis and 74 percent of cases of aortic insufficiency with a 6 percent false positive rate. Multivariate analysis techniques improved performance: 82 percent of the aortic stenosis records and 78 percent of the aortic insufficiency records were correctly recognized as showing left ventricular overload; the false positive rate was 5 percent. Although many electrocardiographic measurements were significantly correlated with the aortic valve gradient, correlations were not high enough for use in predicting the severity of the aortic stenosis. Comparison of electrocardiographic variables in aortic stenosis and aortic insufficiency demonstrated a wide overlap between groups, and the electrocardiographic changes of aortic stenosis could not be differentiated from those of aortic insufficiency.
D001022:Aortic Valve Insufficiency / Q000175:diagnosis*; D001024:Aortic Valve Stenosis / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted; D004562:Electrocardiography; D006801:Humans; D009200:Myocardial Contraction; D014672:Vectorcardiography