Riggs T, Mehta S, Hirschfeld S, Borkat G, Liebman J
Circulation. 1979 Feb;59(2):385-94. doi: 10.1161/01.cir.59.2.385.
Echocardiograms (echo) and vectorcardiograms (VCG) from 40 infants with ventricular septal defects (VSD) were compared with cardiac catheterization data to assess noninvasively the hemodynamics of VSD. The specific aim was to use VCG parameters of right ventricular hypertrophy and echo parameters which reflect pulmonary artery pressure to identify all patients with a nonrestrictive VSD. The configuration of the QRS vector in the horizontal plane was more reliable than individual voltages in assessing right ventricular systolic pressure. Among patients older than 2 months with a clockwise or anterior two-main-vector horizontal loop, 73% (eight of 11) had a nonrestrictive VSD. However, a counterclockwise or posterior two-main-vector loop was also frequently found (43%, six of 14) in infants with a nonrestrictive VSD. The most useful echo parameter was the ratio of right ventricular preejection period-to-right ventricular ejection time (RPEP/RVET), which closely (r = 0.74) reflected the pulmonary artery diastolic pressure. An elevated RPEP/RVET to greater than 0.30 was always associated with a nonrestrictive VSD, although many patients (36%, five of 14) with a nonrestrictive VSD had a normal ratio. By combining both echo and VCG parameters, a nonrestrictive VSD was correctly identified in all patients, while a restrictive VSD was correctly identified in 81% (21 of 26).
对40例室间隔缺损（VSD）婴儿的超声心动图（echo）和向量心电图（VCG）与心导管检查数据进行比较，以无创评估VSD的血流动力学。具体目的是使用反映肺动脉压力的右心室肥厚的VCG参数和echo参数来识别所有非限制性VSD患者。在评估右心室收缩压时，水平面QRS向量的形态比单个电压更可靠。在2个月以上、具有顺时针或前双主向量水平环的患者中，73%（11例中的8例）有非限制性VSD。然而，在非限制性VSD婴儿中也经常发现逆时针或后双主向量环（43%，14例中的6例）。最有用的echo参数是右心室射血前期与右心室射血时间之比（RPEP/RVET），它与肺动脉舒张压密切相关（r = 0.74）。RPEP/RVET升高至大于0.30总是与非限制性VSD相关，尽管许多非限制性VSD患者（36%，14例中的5例）该比值正常。通过结合echo和VCG参数，所有患者中均正确识别出非限制性VSD，而81%（26例中的21例）正确识别出限制性VSD。
