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European Heart Journal 1983 4(2):103-109;
Copyright © 1983 by the European Society of Cardiology.
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© 1983 The European Society of Cardiology

Reassessment of the relation between QRS forces of the orthogonal electrocardiogram and left ventricular ejection fraction

R. J. LUWAERT*, J. COSYNS, M. F. ROUSSEAU, L. A. BRASSEUR, J. M. DETRY and C. R. BROHET

Division of Cardiology and Cardiopulmonary Laboratory, University of Louvain Brussels, Belgium

Received 5 February 1982; revised 28 March 1982; .

Requests for reprints to: Dr C. R. Brohet, Cardiopulmonary Laboratory, Division of Cardiology, Cliniques Universitaires Saint-Luc, av. Hippocrate 10, B-120 Brussels, Belgium.

Abstract

Previous studies have demonstrated the existence of a strong positive correlation between the amplitude of QRS forces of the orthogonal electrocardiogram and the angiographically determined left ventricular ejection fraction. In a large group of patients evaluated for chest pain, we examined the relationship between the arithmetic summation of Rx+Ry+Qz ({Sigma}R) the maximal and mean spatial QRS vectors and the ejection fraction (EF). In a total of 252 patients, there was a statistically significant correlation between {Sigma}R and EF but a low correlation coefficient value (r: 0.22, P<0.001). This relationship was essentially due to the group of patients with coronary artery disease and myocardial infarction (r: 0.24, P<0.015) whereas there was no correlation in the group of normal subjects or in patients with coronary artery disease without myocardial infarction. In the group with myocardial infarction, a significant correlation between {Sigma}R and EF existed only in patients with anterior myocardial infarction (r: 0.41, P<0.025). In conclusion, both ejection fraction and amplitude of QRS forces decrease in coronary artery disease especially when an anterior myocardial infarction is present. However, despite the positive association between these angiographic and electrocardiographic indices, the low value of the correlation coefficient indicates that it is not possible to predict ejection fraction from the value of {Sigma}R in individual patients.

Key Words: Computerized orthogonal electrocardiogram • ejection fraction • coronary artery disease • myocardial infarction


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