Adv. Cardiol., vol. 19, pp. 211-214 (Karger, Basel 1977)

Vectorcardiographic Load Test in Ischemic Heart Disease V. KRAL, Z. DRSKA, V. NOVAK and V. JEZEK. Laboratory of Graphic Diagnostics of the Czechoslovak Academy of Sciences, and lst Surgical Clinic of the Charles University, Prague

A load test as a model for the determination of certain types of coronary affliction [1-3] was performed. In a group of 50 persons with ischemic heart disease, verified by angiography, the bicycle-ergometer load test was implied. The strain was successively increased from 0.5 W/kg up to the submaximal load according to currently used criteria, or until angina pain appeared. After the termination of the load the vectorcardiographic Frank leads were recorded on line into computer PDP-12. The vectorcardiograms were registered at intervals until normalization was stated. The processing of data was done by semiautomatic program selecting spatial module and velocity [1]. T loop is presented always as a

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Fig. 1. Vectorcardiographic ST-T changes after load in group I.

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Fig. 3. Group III, afterload vectorcardiographic changes.

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Group I: The direction of T loop is altered to the right and backwards and, by the rotation along the longitudinal axis, returns in azimuthal anterior rotation at the rest position; the ST vector is oriented superiorly (fig. 1). Mostly patients with changes of the anterior, apical and lateral parts of the left ventricle wall were included here. Group II: The load provokes rotations of T loop to the left and backwards along the longitudinal T axis, then follows the rest position. Included were persons with ischemia on the anterior bottom part of the left ventricle and also several patients with the affliction of the right coronary artery (fig. 2). Group III: This group comprises persons with inversed rotation of T loop, which is oriented backwards to the right even at ease phase. The ischemia provoked by the load causes anterior most rightward T rotation (fig. 3). It always concerned patients with affliction in the region of the left coronary artery, frequently with post-infarction changes. The participation of the right coronary artery is presented by cranial rotation of the maximum T vector. All three groups presented load changes of the loops characterized by the deviation from the ischemic source and with successive return which corresponded to the restitution of the ischemic myocardium (fig. 4). The type of spatial changes of electrical T field depends upon the localization of temporary ischemia, and upon the well preserved functional contractile myocardium.

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Fig. 4. Maps of T normals position changes after load in healthy subjects and in patients in groups I, II, III with ischemic heart disease.

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References

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KRAL, V.: Myocardial infarction in VCG picture; in ScHuBERT Neue Ergebnisse der Elektrokardiologie, pp. 135-138 (Fischer, Jena 1974). KRAL, V.: VCG in cardiac aneurysm; in DoUBJIAN New trends in electrocardiology, pp. 254-255 (yerevan 1973). KRAL, V.; NOVAK, V., and JdEK, V.: The relation of repolarisation potentials to the localisation of transmural infarctions; in ABEL Electrocardiology, pp. 445-449 (Karger, Basel 1976).

Dr. V. KRAL, Laboratory of Graphic Diagnostics of the Czechoslovak Academy of Sciences, Prague (Czechoslovakia)

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Vectorcardiographic load test in ischemic heart disease.

Adv. Cardiol., vol. 19, pp. 211-214 (Karger, Basel 1977) Vectorcardiographic Load Test in Ischemic Heart Disease V. KRAL, Z. DRSKA, V. NOVAK and V. J...
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