Curtiss E I, Cecchetti A A
J Electrocardiol. 1983 Jan;16(1):53-8. doi: 10.1016/s0022-0736(83)80159-9.
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.
在一系列连续的患者（291例心脏病患者和135例对照者）中，研究了向量心电图相对QRS环面积标准在识别与选择性右心室负荷过重相关的心脏病变患者中显著血流动力学异常（平均肺动脉压大于25 mmHg和/或肺循环与体循环血流比大于1.5）的效用。各个异常增加的右象限面积的特异性和预测价值分别大于90%和大于80%。在识别无显著血流动力学异常方面（=91%），孤立的左前面积增加大于70%的预测价值与阴性向量心电图（=80%）相似。仅在伴有逆时针横面QRS环旋转时发现右象限面积出现假阳性增加。通过将右下和后面积异常增加的诊断要求分别从20%提高到26%，逆时针环的预测价值从77%上升到86%。
