Fischer D M, Benini A, Andraghetti A, Pirazzini L, Patroncini A, Fabbri M
G Ital Cardiol. 1983;13(2):106-12.
The purpose of this work is to verify if the vectorcardiogram (VCG) can be used for the quantification of old myocardial infarction (OMI). 50 cases of acute myocardial infarction were studied by mean of seriate determination of MB-CK isoenzyme and Sobel Index (SI); 4 weeks later, Frank's VCG was recorded. The studied cases did not show any conduction disturbances or other electrical abnormalities besides the sign of OMI. The 50 cases were divided into two groups according to the site of the necrosis: Group A, including 27 cases of inferior and/or posterior infarction and Group B, including 23 cases of septal and/or anterior infarction. On the VCG records, the variables related to OMI and to the general shape of ventricular depolarization and repolarization were measured. The electrical variables and the SI were compared by means of the methods of linear regression and of principal components analysis. No significant correlations were detected. Therefore, we conclude that the VCG is useless in the quantitative assessment of OMI; that such terms as "extensive, localized" and so on, at present widely used in electro- and vector-cardiography, are misleading if based only on surface electrical records obtained at distance from the acute phase of infarction and should therefore be avoided; that the work is consistent with the hypothesis that the electrical pattern of OMI could depend mainly upon peripheral intraventricular conduction disturbances.
本研究的目的是验证向量心电图（VCG）是否可用于定量评估陈旧性心肌梗死（OMI）。通过连续测定肌酸激酶同工酶MB（MB-CK）和索贝尔指数（SI）对50例急性心肌梗死患者进行研究；4周后，记录Frank导联VCG。研究对象除OMI征象外，未显示任何传导障碍或其他电异常。根据梗死部位将50例患者分为两组：A组，包括27例下壁和/或后壁梗死患者；B组，包括23例间隔和/或前壁梗死患者。在VCG记录上，测量与OMI以及心室去极化和复极化总体形态相关的变量。通过线性回归和主成分分析方法比较电变量和SI。未检测到显著相关性。因此，我们得出结论，VCG在OMI的定量评估中无用；目前在心电图和向量心电图中广泛使用的“广泛、局限性”等术语，如果仅基于梗死急性期后远距离获得的体表电记录，则具有误导性，因此应避免使用；本研究结果与OMI电模式可能主要取决于外周心室内传导障碍的假说一致。
