Correlation between the direction of the interventricular septum estimated with transmission computed tomography and the initial QRS vectors.

A correlative study was performed to relate the interventricular septal angle (As degrees) evaluated by transmission computed tomography to the azimuth of initial QRS vectors in 52 patients. Patients were divided into five groups: RV volume overloading (RVO), RV pressure overloading (RSO), LV volume overloading (LVO), LV pressure overloading (LSO), and normal control with no cardiopulmonary disease. For measurement of As degrees, the leftward and forward directions were designated as zero and 90 degrees, respectively. The mean value of As degrees was significantly smaller in RVO (14.4 degrees) and RSO (41.1 degrees) than in normal controls (50.4 degrees) and in LVO (53.2 degrees). The mean value of the azimuth of the initial 12-msec instantaneous QRS vectors (H 12 degrees) was significantly smaller in RVO (80.5 degrees), RSO (81.7 degrees), and LSO (81.3 degrees) than in normal controls (113.8 degrees and in LVO (113.7 degrees). A significant linear correlation was shown between As degrees and H12 degrees in a combined group consisting of RVO, LVO, and normal controls (r = 0.70, p less than 0.001), and also in another combined group consisting of RSO, LSO, and normal controls (r = 0.52, p less than 0.01). It was concluded that the orientation of the interventricular septum was one of the major determinants of the direction of initial QRS vectors, especially in patients with ventricular volume overload or without cardiopulmonary disease.