Howard P F, Benchimol A, Desser K B, Reich F D, Graves C
Am J Cardiol. 1976 Nov 4;38(5):582-7. doi: 10.1016/s0002-9149(76)80006-9.
Electrocardiograms and Frank vectorcardiograms were recorded in 156 consecutive patients with total occlusion of at least one coronary artery (on arteriography) and associated left ventricular contraction abnormality (on ventriculography). The angiograms and cardiograms were independently reviewed. In the presence of single vessel occlusion, appropriate vectorcardiographic diagnosis of myocardial infarction was determined in 118 of 156 cases (76 percent) compared with a lower electrocardiographic detection rate in 77 of 156 cases (49 percent). Findings diagnostic of two coexisting infarctions were observed in 71 percent of vectorcardiograms and 37 percent of electrocardiograms in 51 patients with double vessel occlusion and two areas of left ventricular dyskinesia. The vectorcardiographic detection rate was similarly superior to the electrocardiographic rate in the presence of subtotal coronary occlusion and myocardial asynergy in single (73 percent versus 53 percent) and double (53 percent versus 28 percent) vessel disease. The incidence rate of false positive diagnoses was 3 percent for electrocardiography and 4 percent for vectorcardiography. It is concluded that the vectorcardiogram is superior to the electrocardiogram in the diagnosis of obstructive coronary artery disease and left ventricular contraction abnormality.
对156例（经动脉造影证实）至少有一支冠状动脉完全闭塞且（经心室造影证实）伴有左心室收缩异常的连续患者进行了心电图和Frank向量心电图记录。血管造影和心电图由不同人员独立审查。在单支血管闭塞的情况下，156例中有118例（76%）通过向量心电图做出了恰当的心肌梗死诊断，相比之下，156例中只有77例（49%）通过心电图检测出心肌梗死，检测率较低。在51例双支血管闭塞且存在两个左心室运动障碍区域的患者中，71%的向量心电图和37%的心电图发现了并存的两处梗死诊断。在单支血管病变（73%对53%）和双支血管病变（53%对28%）伴有冠状动脉次全闭塞和心肌协同失调的情况下，向量心电图的检测率同样高于心电图检测率。心电图的假阳性诊断发生率为3%，向量心电图为4%。结论是，在诊断阻塞性冠状动脉疾病和左心室收缩异常方面，向量心电图优于心电图。
