Features of vectorcardiograms in patients with hypertension complicated by chronic heart failure with reduced left ventricle ejection fraction

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Abstract

Aim. To explore the features of vectorcardiograms (VCG) of patients with essential hypertension complicated by chronic heart failure with reduced left ventricular ejection fraction (CHFrLVEF).

Materials and methods. We analyzed VCGs of 70 hypertensive patients with CHFrLVEF and 275 hypertensive patients without clinical signs of CHF and with LVEF>50%. We assessed the presence of rhythm and conduction disturbances, and the parameters of the synthesized VCG, i.e., module of the maximum QRS vector, planarity index of the spatial QRS loop (P/S), and spatial angle between the integral QRS and T vectors (sQRS-Ta).

Results. In hypertensive patients with CHF, certain conditions were detected more often as compared with hypertensive patients without CHF, i.e., atrial fibrillation (AF) in 52.9% vs 5.1%; p<0.0001, and left bundle branch block (LBBB) in 38.6% vs 0.4%; p<0.0001. The module of the maximum QRS vector and sQRS-Ta were significantly greater and P/S was significantly less in VCGs of patients with CHF. ROC-analysis showed that the presence of AF and LBBB just as VCG parameters assessed in this study provide clear discrimination between hypertensive patients with or without CHF both in the group as a whole and in the subgroups (1) without LBBB, (2) with sinus rhythm, and (3) with AF. sQRS-Ta was the most informative parameter (threshold >137°, sensitivity 91%, specificity 92%). The P/S indicator at the optimal threshold value ≤0.92 was characterized by lower specificity (68%) with rather high sensitivity (79%).

Conclusion. AF, LBBB, increased module of the maximum QRS vector and sQRS-Ta, and decreased P/S index are present in hypertensive patients with CHFrLVEF as compared with patients without CHF.

About the authors

Tamara A. Sakhnova

Chazov National Medical Research Center of Cardiology

Author for correspondence.
Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0002-5543-7184

канд. мед. наук, ст. науч. сотр. лаб. ЭКГ Института клинической кардиологии им. А.Л. Мясникова

Russian Federation, Moscow

Elena V. Blinova

Chazov National Medical Research Center of Cardiology

Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0001-8725-7084

канд. мед. наук, науч. сотр. лаб. ЭКГ Института клинической кардиологии им. А.Л. Мясникова

Russian Federation, Moscow

Elena S. Yurasova

Chazov National Medical Research Center of Cardiology

Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0002-4640-5578

канд. мед. наук, вед. науч. сотр. научно-экспертного отд. Института клинической кардиологии им. А.Л. Мясникова

Russian Federation, Moscow

Tatiana M. Uskach

Chazov National Medical Research Center of Cardiology

Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0003-4318-0315

д-р мед. наук, вед. науч. сотр. отд. заболеваний миокарда и сердечной недостаточности Института клинической кардиологии им. А.Л. Мясникова

Russian Federation, Moscow

Nataliya V. Blinova

Chazov National Medical Research Center of Cardiology

Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0001-5215-4894

канд. мед. наук, ст. науч. сотр. отд. гипертонии Института клинической кардиологии им. А.Л. Мясникова

Russian Federation, Moscow

Eduard A.I. Aidu

Kharkevich Institute for Information Transmission Problems

Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0001-9505-4404

канд. техн. наук, ст. науч. сотр. лаб. теории передачи информации и управления

Russian Federation, Moscow

Vladimir G. Trunov

Kharkevich Institute for Information Transmission Problems

Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0002-6084-1608

канд. техн. наук, вед. науч. сотр. лаб. теории передачи информации и управления

Russian Federation, Moscow

Marina A. Saidova

Chazov National Medical Research Center of Cardiology

Email: tamara-sahnova@mail.ru
ORCID iD: 0000-0002-3233-1862

гл. науч. сотр. отд. ультразвуковых методов исследования Института клинической кардиологии им. А.Л. Мясникова

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Electrocardiogram and vectorcardiogram of a hypertensive patient with CHF. MQRS 1,96 mV, sQRS-Ta 175°, P/S 0,52.

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3. Fig. 2. Electrocardiogram and vectorcardiogram of a patient with AH without CHF. MQRS 1,42 mV, sQRS-Ta 83°, P/S 0,96.

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