Left ventricular hypertrophy index based on a combination of frontal and transverse planes in the ECG and VCG: Diagnostic utility of cardiac vectors

BONOMINI M.P.; INGALLINA F.; BARONE V.; ANTONUCCI, R.; VALENTIBUZZI, MAXIMO E.; ARINI P.D.

Congreso; XX Congreso Argentino de Bioingeniería, IX Jornadas de Ingeniería Clínica; 2015

Soc. Argentina de Bioingenieria

The changes that left ventricular hypertrophy (LVH)induces in depolarization and repolarization vectors are well known. Weanalyzed the performance of the electrocardiographic and vectorcardiographictransverse planes (TP in the ECG and XZ in the VCG) and frontal planes (FP inthe ECG and XY in the VCG) to discriminate LVH patients from control subjects. Inan age-balanced set of 58 patients, the directions and amplitudes ofQRS-complexes and T-wave vectors were studied. The repolarization vectorsigni_cantly decreased in modulus from controls to LVH in the transverse plane(TP: 0.45±0.17mV vs. 0.24±0.13mV, p<0.0005; XZ: 0.43±0.16mV vs. 0.26±0.11mV,p<0.005) while the depolarization vector significantly changed in angle inthe electrocardiographic frontal plane (Controls vs. LVH, FP: 48.24±33.66 vs. -46.84±35.44,p<0.005, XY: 20.28±35.20 vs. 19.35±12.31, NS). Several LVH indexes were proposedcombining such information in both ECG and VCG spaces. A subset of all those indexeswith AUC values greater than 0.7 was further studied. This subset comprisedfour indexes, with three of them belonging to the ECG space. Two out of thefour indexes presented the best ROC curves (AUC values: 0.78 and 0.75,respectively). One index belonged to the ECG space and the other one to the VCGspace. Both indexes showed a sensitivity of 86% and a specificity of 70%. In conclusion, the proposed indexes canfavorably complement LVH diagnosis.