Astorri E, Cuminetti S, Pasini G P, Barilli L A, Colla B, Visioli O
G Ital Cardiol. 1980;10(10):1308-20.
This study on rest and exercise atrial vectorcardiogram (Frank method) was carried out on a group of 27 healthy volunteers (Group A) and on a group of 24 patients with mitral stenosis (Group B). All 51 subjects were women. Our original program was performed using a Hewlett Packard 2100 computer. The pattern recognition of every wave was carried out by analysing a particular function obtained by translating the X, Y, Z leads on the line joining the T-P, P-Q, ST segments. In the group B on rest a significant correlation between atrial vectorcardiogram parameters and pulmonary capillary wedge pressure was not present. Between both group A and B the vectorcardiographic data were greatly superposables. It is difficult, because of the great interindividual variability of results obtained, to have very discriminant vectorcardiographic parameters between group A and group B on rest and during exercise, performed in the supine position with a bicycle ergometer. In the both groups A and B the exercise induces a significant increase of spatial magnitude of maximal P xyz vector (max P xyz) and maximal P amplitude on frontal and sagittal planes, with P loop shifting towards a vertical position. The following significant results were observed only in group B of mitral patients: 1) an increase of P wave duration; 2) an increase of the interval between the two peaks of P wave (measurable only in group B); 3) an increase in the amplitude and backward rotation of max P xyz azimuth and of the maximal vector backward directed on horizontal (H) plane; 4) an increase of P loop linear, tangential and areolar velocities. The P loop anterior and posterior area on H plane and of the spatial P xyz vectors changes during exercise were directionally similar in the normal group and in the patients with mitral stenosis. These results suggest a little diagnostic power of the P wave area changes during exercise. In both groups maximal atrial T vector increases with exertion, but only in group B migrates backward on H plane, suggesting an atrial gradient directed towards the left atrium.
本研究采用心房向量心电图（Frank 法），对一组 27 名健康志愿者（A 组）和一组 24 名二尖瓣狭窄患者（B 组）进行了研究。所有 51 名受试者均为女性。我们最初的程序是使用惠普 2100 计算机执行的。通过分析在连接 T - P、P - Q、ST 段的线上平移 X、Y、Z 导联所获得的特定函数，对每个波进行模式识别。在 B 组静息状态下，心房向量心电图参数与肺毛细血管楔压之间不存在显著相关性。A 组和 B 组之间的向量心电图数据有很大的重叠性。由于所获得结果的个体间差异很大，因此很难在仰卧位使用自行车测力计进行静息和运动时，获得 A 组和 B 组之间具有很强鉴别力的向量心电图参数。在 A 组和 B 组中，运动均导致最大 P xyz 向量（max P xyz）的空间幅度以及额面和矢状面上最大 P 波振幅显著增加，P 环移向垂直位置。仅在二尖瓣患者的 B 组中观察到以下显著结果：1）P 波持续时间增加；2）P 波两个峰值之间的间隔增加（仅在 B 组中可测量）；3）max P xyz 方位角和水平（H）面上最大向后指向向量的振幅增加和向后旋转；4）P 环线性、切线和面积速度增加。在 H 平面上 P 环前后面积以及运动期间空间 P xyz 向量的变化在正常组和二尖瓣狭窄患者中方向相似。这些结果表明运动期间 P 波面积变化的诊断价值不大。在两组中，最大心房 T 向量随运动增加，但仅在 B 组中在 H 平面上向后迁移，提示存在指向左心房的心房梯度。
