Background

Vectorcardiography (VCG) has demonstrated diagnostic value in the assessment of hypertrophic cardiomyopathy (HCM), however, determining its prognostic value over time has not yet been investigated. This study sought to assess the correlation of VCG parameters with the progression of HCM.

Methods

A retrospective chart review of 119 pediatric patients with diagnosis of HCM at the University of Minnesota. Eighty-three cases were excluded because of age, presence of congenital heart disease, not meeting criteria for HCM or negative phenotype. Sample was divided into 2 groups based on the presence or not of cardiac events (ventricular tachycardia, cardiac arrest, ventricular assist device, heart transplant). Derived vectorcardiography from standard 12‑lead ECG was obtained for the first ECG and last available or prior to sentinel event.

Results

Of the 36 cases that met inclusion criteria, 9 (25%) developed a sentinel event. The median age for the event group was 10.1 ± 7.5 years and for the non-event group was 8.7 ± 6.35 years. There was no significant difference in age or sex between the groups.

The T wave vector magnitude value was significantly smaller in the event group than in the non-event group (0.302 ± 0.146 mV Vs. 0.561 ± 0.305 mV, p 0.002), with a hazard ratio of 0.651 (95% CI 0.463 to 0.915). No other parameter showed significant difference between the two groups.

Conclusions

The T wave vector magnitude may predict sentinel events in HCM. Prospective studies are necessary to evaluate the utility of the evolution of VCG parameters.

中文翻译：

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矢量心电图作为肥厚型心肌病的预后工具

背景

矢量心电图 (VCG) 已证明在评估肥厚型心肌病 (HCM) 方面具有诊断价值，但尚未研究确定其随时间推移的预后价值。本研究旨在评估 VCG 参数与 HCM 进展的相关性。

方法

对明尼苏达大学诊断为 HCM 的 119 名儿科患者的回顾性图表审查。83 例因年龄、先天性心脏病、不符合 HCM 标准或阴性表型而被排除在外。根据是否存在心脏事件（室性心动过速、心脏骤停、心室辅助装置、心脏移植）将样本分为 2 组。从标准 12 导联心电图获得的矢量心电图是第一次和最后一次可用的或在哨兵事件之前获得的。

结果

在符合纳入标准的 36 例病例中，9 例（25%）发生了哨点事件。事件组的中位年龄为 10.1 ± 7.5 岁，非事件组的中位年龄为 8.7 ± 6.35 岁。各组之间的年龄或性别没有显着差异。

事件组的 T 波矢量幅度值显着小于非事件组（0.302 ± 0.146 mV Vs. 0.561 ± 0.305 mV，p = 0.002），风险比为 0.651（95% CI 0.463 至 0.915） . 没有其他参数显示两组之间有显着差异。

结论

T 波矢量幅度可以预测 HCM 中的前哨事件。有必要进行前瞻性研究来评估 VCG 参数演变的效用。