Rissanen V, Raunio H, Lampainen E
Ann Clin Res. 1976 Dec;8(6):359-67.
The mean electrical QRS axis (AQRS) on the frontal plane was determined on electrocardiograms recorded shortly before death in 1249 patients. Cardiopulmonary diseases were sought at autopsy. Cases with CRBBE, CLBBB, WPW or idioventricular rhythm were excluded. In 171 patients without cardiopulmonary diseases, the AQRS tended to deviate to the left with age. In patients aged 30--49 the median AQRS was +55 degrees ranging between -30 degrees--90. In 99% of older patients, it stayed between -45 degrees--75 degrees. No sex difference was found. A large AQRS deviation was characteristic of patients with cardiopulmonary diseases. In one third of male pulmonary patients aged 50 or over, the AQRS pointed outside -45 degrees or +75 degrees. Rightward deviation of +90 degrees was found in 20% of younger patients. In patients aged 50 or over with myocardial infarction, rightward AQRS deviation of +75 degrees was observed in 11%, and below -45 degrees in 8% of the patients. Abnormal deviation was most common in association with inferoposterior or lateral wall infarctions. Abnormal deviation of the frontal plane QRS axis seems to coincide only with cardiac or pulmonary diseases. Extreme rightward deviation suggests a condition of right ventricular overload, but leftward deviation occurs in patients with pulmonary and with left ventricular diseases.
在1249例患者死亡前不久记录的心电图上测定额面平均电轴（AQRS）。尸检时查找心肺疾病。排除完全性右束支传导阻滞（CRBBE）、完全性左束支传导阻滞（CLBBB）、预激综合征（WPW）或心室自主节律患者。在171例无心肺疾病的患者中，AQRS有随年龄向左偏移的趋势。年龄在30至49岁的患者中，AQRS中位数为+55度，范围在-30度至90度之间。在99%的老年患者中，AQRS保持在-45度至75度之间。未发现性别差异。AQRS大偏移是心肺疾病患者的特征。在50岁及以上的男性肺部疾病患者中，三分之一的患者AQRS指向-45度以外或+75度以外。在20%的年轻患者中发现电轴右偏达+90度。在50岁及以上的心肌梗死患者中，11%的患者观察到AQRS右偏达+75度，8%的患者低于-45度。异常偏移最常见于下后壁或侧壁梗死。额面QRS电轴异常偏移似乎仅与心脏或肺部疾病相关。极度右偏提示右心室负荷过重，但左偏见于肺部疾病和左心室疾病患者。
