QRS loop areas in selective right ventricular overload: relation to hemodynamic status.
The utility of vectorcardiographic relative QRS loop area criteria in identifying significant hemodynamic abnormality (a mean pulmonary artery pressure greater than 25 mmHg and/or a pulmonary to systemic flow ratio greater than 1.5) in patients with cardiac lesions associated with selective right ventricular overload was investigated in a consecutive series of patients, 291 with Heart Disease and 135 Controls. The specificity and predictive value of individual abnormally increased right quadrant areas were greater than 90% and greater than 80%, respectively. The predictive value of an isolated increase in left anterior area greater than 70% in identifying the absence of significant hemodynamic abnormality (= 91%) was similar to a negative VCG (= 80%). False positive increases in right quadrant areas were found only in association with counterclockwise transverse plane QRS loop rotation. The predictive value of a counterclockwise loop rose from 77% to 86% by increasing the diagnostic requirement for an abnormal increase in right inferior and posterior area from 20%, respectively, to 26%, respectively.
D000293:Adolescent; D000328:Adult; D000368:Aged; D006332:Cardiomegaly / Q000175:diagnosis*; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D014672:Vectorcardiography