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Пространственная векторкардиография: от истоков до наших дней - Журнал Терапевтический архив №4 Вопросы диагностики внутренних болезней 2025
Пространственная векторкардиография: от истоков до наших дней
Олейников В.Э., Чернова А.А. Пространственная векторкардиография: от истоков до наших дней. Терапевтический архив. 2025;97(4):360–366. DOI: 10.26442/00403660.2025.04.203149
© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Векторкардиография (ВКГ) зародилась еще в 1887 г. благодаря открытию дипольной теории электрического вектора сердца A. Waller. Несмотря на то что идея построения электрического вектора сердца быстро получила признание среди ученых того времени, технические несовершенства электрокардиографов и трудоемкость ручных расчетов на определенный промежуток времени снизили интерес исследователей к данному методу. Появление цифровых электрокардиографов и разработка алгоритмов автоматического построения векторов сердца подарили ВКГ вторую жизнь и позволили взглянуть на векторную теорию под иным углом. Стало возможным визуализировать электрические процессы миокарда в трехмерном изображении, производить расчет параметров векторов деполяризации и реполяризации. В обзоре обобщены имеющиеся на настоящее время представления и результаты исследований, посвященных изучению ВКГ. Обсуждаются концепции глобальной электрической гетерогенности и желудочкового градиента, основанные на векторной теории сердца. Приводятся данные многочисленных исследований, свидетельствующих о значимой прогностической и диагностической ценности полученных параметров ВКГ.
Ключевые слова: векторкардиография, цифровая электрокардиография, глобальная электрическая гетерогенность, желудочковый градиент, электрическая нестабильность миокарда
Keywords: vectorcardiography, digital electrocardiography, global electrical heterogeneity, ventricular gradient, electrical instability of the myocardium
Ключевые слова: векторкардиография, цифровая электрокардиография, глобальная электрическая гетерогенность, желудочковый градиент, электрическая нестабильность миокарда
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Keywords: vectorcardiography, digital electrocardiography, global electrical heterogeneity, ventricular gradient, electrical instability of the myocardium
Полный текст
Список литературы
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33. Waks JW, Sitlani CM, Soliman EZ, et al. Global electric heterogeneity risk score for prediction of sudden cardiac death in the general population: The Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health (CHS) studies. Circulation. 2016;133(23):2222-34. DOI:10.1161/CIRCULATIONAHA.116.021306
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35. Tereshchenko LG, Feeny A, Shelton E, et al. Dynamic changes in high-sensitivity cardiac troponin I are associated with dynamic changes in sum absolute QRST integral on surface electrocardiogram in acute decompensated heart failure. Ann Noninvasive Electrocardiol. 2017;22(1):e12379. DOI:10.1111/anec.12379
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2. Einthoven W, Fahr G, de Waart A. Über die Richtung und die manifeste Grösse der Potentialschwankungen im menschlichen Herzen und über den Einfluss der Herzlage auf die Form des Elektrokardiogramms. Pflugers Arch ges Physiol. 1913;150:275-315.
3. Mann H. А method of analyzing the electrocardiogram. Arch Intern Med (Chic). 1920;25(3):283-94.
4. Burch GE. The history of vectorcardiography. Med Hist Suppl. 1985;(5):103-31. PMID:3915520
5. Wilson FN, Macleod AG, Barker PS, Johnston FD. The determination and the significance of the areas of the ventricular deflections of the electrocardiogram. Am Heart J. 1934;10(1):46-61.
6. Wilson FN, MacLeod AG, Barker PS. The T deflection of the electrocardiogram. Trans Assoc Am Physicians. 1931;46:29-38.
7. Grishman A, Borun ER, Jaffe HL. Spatial vectorcardiography: Technique for the simultaneous recording of the frontal, sagittal, and horizontal projections. Am Heart J. 1951;41(4):483-93. PMID:14818957
8. Milnor WR, Talbot SA, Newman EV. A study of the relationship between unipolar leads and spatial vectorcardiograms, using the panoramic vectorcardiograph. Circulation. 1953;7(4):545-57. PMID:13033081
9. Frank E. An accurate, clinically practical system for spatial vectorcardiography. Circulation. 1956;13(5):737-49. PMID:13356432
10. Burch GE, Abildskov AA, Cronvich JA. A study of the spatial vectorcardiogram of the ventricular gradient. Circulation. 1954;9(2):267-75. PMID:13127188
11. Simonson E, Schmitt OH, Dahl J, et al. The theoretical and experimental bases of the frontal plane ventricular gradient and its spatial counterpart. Am Heart J. 1954;47(1):122-53. PMID:13114180
12. Burger HC. A theoretical elucidation of the notion ventricular gradient. Am Heart J. 1957;53(2):240-6. PMID:13394523
13. Gardberg M, Rosen IL. Monophasic curve analysis and the ventricular gradient in the electrogram of strips of turtle ventricle. Circ Res. 1959;7:870-5. PMID:13826483
14. Lux RL, Urie PM, Burgess MJ, Abildskov JA. Variability of the body surface distributions of QRS, ST-T and QRST deflection areas with varied activation sequence in dogs. Cardiovasc Res. 1980;14(10):607-12. PMID:7214395
15. Sridharan MR, Horan LG, Hand RC, et al. The determination of the human ventricular gradient from body surface potential map data. J Electrocardiol. 1981;14(4):399-406. PMID:7299310
16. Geselowitz DB. The ventricular gradient revisited: Relation to the area under the action potential. IEEE Trans Biomed Eng. 1983;30(1):76-7. PMID:6826192
17. Yurasova ES, Blinova EV, Sakhnova TA. On the history of vectorcardiography: Past, present, future. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1122-5 (in Russian). DOI:10.26442/00403660.2022.09.201841
18. Vondrak J, Penhaker M. Review of processing pathological vectorcardiographic records for the detection of heart disease. Front Physiol. 2022;13:856590. DOI:10.3389/fphys.2022.856590
19. Prenner SB, Shah SJ, Goldberger JJ, Sauer AJ. Repolarization heterogeneity: Beyond the QT interval. J Am Heart Assoc. 2016;5(5):e003607. DOI:10.1161/JAHA.116.003607
20. Draisma HH, Schalij MJ, van der Wall EE, Swenne CA. Elucidation of the spatial ventricular gradient and its link with dispersion of repolarization. Heart Rhythm. 2006;3(9):1092-9. DOI:10.1016/j.hrthm.2006.05.025
21. Hurst JW. Thoughts about the ventricular gradient and its current clinical use (part II of II). Clin Cardiol. 2005;28(5):219-24. DOI:10.1002/clc.4960280504
22. Waks JW, Tereshchenko LG. Global electrical heterogeneity: A review of the spatial ventricular gradient. J Electrocardiol. 2016;49(6):824-30. DOI:10.1016/j.jelectrocard.2016.07.025
23. Tereshchenko LG. Global electrical heterogeneity: Mechanisms and clinical significance. Comput Cardiol (2010). 2018;45:10.22489/cinc.2018.165. DOI:10.22489/cinc.2018.165
24. Kors JA, Kardys I, van der Meer IM, et al. Spatial QRS-T angle as a risk indicator of cardiac death in an elderly population. J Electrocardiol. 2003;36(Suppl.):113-4. DOI:10.1016/j.jelectrocard.2003.09.033
25. Yamazaki T, Froelicher VF, Myers J, et al. Spatial QRS-T angle predicts cardiac death in a clinical population. Heart Rhythm. 2005;2(1):73-8. DOI:10.1016/j.hrthm.2004.10.040
26. Aro AL, Huikuri HV, Tikkanen JT, et al. QRS-T angle as a predictor of sudden cardiac death in a middle-aged general population. Europace. 2012;14(6):872-6. DOI:10.1093/europace/eur393
27. Zhang ZM, Prineas RJ, Case D, et al.; ARIC Research Group. Comparison of the prognostic significance of the electrocardiographic QRS/T angles in predicting incident coronary heart disease and total mortality (from the atherosclerosis risk in communities study). Am J Cardiol. 2007;100(5):844-9. DOI:10.1016/j.amjcard.2007.03.104
28. Blinova EV, Sakhnova TA, Yurasova ES. Diagnostic and prognostic significance of QRS-T angle. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(9):85-93 (in Russian). DOI:10.26442/00403660.2020.09.000752
29. Tereshchenko LG, Cheng A, Fetics BJ, et al. Ventricular arrhythmia is predicted by sum absolute QRST integralbut not by QRS width. J Electrocardiol. 2010;43(6):548-52. DOI:10.1016/j.jelectrocard.2010.07.013
30. Tereshchenko LG, McNitt S, Han L, et al. ECG marker of adverse electrical remodeling post-myocardial infarction predicts outcomes in MADIT II study. PLoS One. 2012;7(12):e51812. DOI:10.1371/journal.pone.0051812
31. Sur S, Han L, Tereshchenko LG. Comparison of sum absolute QRST integral, and temporal variability in depolarization and repolarization, measured by dynamic vectorcardiography approach, in healthy men and women. PLoS One. 2013;8(2):e57175. DOI:10.1371/journal.pone.0057175
32. Pueyo E, Corrias A, Virág L, et al. A multiscale investigation of repolarization variability and its role in cardiac arrhythmogenesis. Biophys J. 2011;101(12):2892-902. DOI:10.1016/j.bpj.2011.09.060
33. Waks JW, Sitlani CM, Soliman EZ, et al. Global electric heterogeneity risk score for prediction of sudden cardiac death in the general population: The Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health (CHS) studies. Circulation. 2016;133(23):2222-34. DOI:10.1161/CIRCULATIONAHA.116.021306
34. Biering-Sørensen T, Kabir M, Waks JW, et al. Global ECG measures and cardiac structure and function: The ARIC Study (Atherosclerosis Risk in Communities). Circ Arrhythm Electrophysiol. 2018;11(3):e005961. DOI:10.1161/CIRCEP.117.005961
35. Tereshchenko LG, Feeny A, Shelton E, et al. Dynamic changes in high-sensitivity cardiac troponin I are associated with dynamic changes in sum absolute QRST integral on surface electrocardiogram in acute decompensated heart failure. Ann Noninvasive Electrocardiol. 2017;22(1):e12379. DOI:10.1111/anec.12379
36. Javed N, El-Far M, Vittorio TJ. Clinical markers in heart failure: A narrative review. J Int Med Res. 2024;52(5):3000605241254330. DOI:10.1177/03000605241254330
37. Perez-Alday EA, Bender A, German D, et al. Dynamic predictive accuracy of electrocardiographic biomarkers of sudden cardiac death within a survival framework: The Atherosclerosis Risk in Communities (ARIC) study. BMC Cardiovasc Disord. 2019;19(1):255. DOI:10.1186/s12872-019-1234-9
38. Fortune JD, Coppa NE, Haq KT, et al. Digitizing ECG image: A new method and open-source software code. Comput Methods Programs Biomed. 2022;221:106890. DOI:10.1016/j.cmpb.2022.106890
39. Haq KT, Lutz KJ, Peters KK, et al. Reproducibility of global electrical heterogeneity measurements on 12-lead ECG: The multi-ethnic study of atherosclerosis. J Electrocardiol. 2021;69:96-104. DOI:10.1016/j.jelectrocard.2021.09.014
40. Johnson JA, Haq KT, Lutz KJ, et al. Electrophysiological ventricular substrate of stroke: A prospective cohort study in the Atherosclerosis Risk in Communities (ARIC) study. BMJ Open. 2021;11(9):e048542. DOI:10.1136/bmjopen-2020-048542
41. Haq KT, Cao J, Tereshchenko LG. Characteristics of cardiac memory in patients with implanted cardioverter-defibrillators: The Cardiac Memory with Implantable Cardioverter-defibrillator (CAMI) study. J Innov Card Rhythm Manag. 2021;12(2):4395-408. DOI:10.19102/icrm.2021.120204
42. Stabenau HF, Shen C, Tereshchenko LG, et al. Changes in global electrical heterogeneity associated with dofetilide, quinidine, ranolazine, and verapamil. Heart Rhythm. 2020;17(3):460-7. DOI:10.1016/j.hrthm.2019.09.017
43. Peirlinck M, Sahli Costabal F, Kuhl E. Sex differences in drug-induced arrhythmogenesis. Front Physiol. 2021;12:708435. DOI:10.3389/fphys.2021.708435
44. Stabenau HF, Shen C, Zimetbaum P, et al. Global electrical heterogeneity associated with drug-induced torsades de pointes. Heart Rhythm. 2021;18(1):57-62. DOI:10.1016/j.hrthm.2020.07.038
45. Pollard JD, Haq KT, Lutz KJ, et al. Sex differences in vectorcardiogram of African-Americans with and without cardiovascular disease: A cross-sectional study in the Jackson Heart Study cohort. BMJ Open. 2021;11(1):e042899. DOI:10.1136/bmjopen-2020-042899
46. Howell SJ, German D, Bender A, et al. Does sex modify an association of electrophysiological substrate with sudden cardiac death? The Atherosclerosis Risk in Communities (ARIC) study. Cardiovasc Digit Health J. 2020;1(2):80-8. DOI:10.1016/j.cvdhj.2020.08.003
47. Jensen K, Howell SJ, Phan F, et al. Bringing critical race praxis into the study of electrophysiological substrate of sudden cardiac death: The ARIC study. Am Heart Assoc. 2020;9(3):e015012. DOI:10.1161/JAHA.119.015012
48. Jensen CJ, Zadeh B, Wambach JM, et al. Association of QRS-T angle and late gadolinium enhancement in patients with a clinical suspicion of myocarditis. Int J Med Sci. 2021;18(13):2905-9. DOI:10.7150/ijms.57010
49. Zadeh B, Wambach JM, Lambers M, et al. QRS-T-angle in patients with ST-segment Elevation Myocardial Infarction (STEMI) – A comparison with cardiac magnetic resonance imaging. Int J Med Sci. 2020;17(15):2264-8. DOI:10.7150/ijms.44312
50. Jensen CJ, Lambers M, Zadeh B, et al. QRS-T angle in patients with hypertrophic cardiomyopathy – A comparison with cardiac magnetic resonance imaging. Int J Med Sci. 2021;18(3):821-5. DOI:10.7150/ijms.52415
51. Stabenau HF, Marcus M, Matos JD, et al. The spatial ventricular gradient is associated with adverse outcomes in acute pulmonary embolism. Ann Noninvasive Electrocardiol. 2023;28(3):e13041. DOI:10.1111/anec.13041
52. Sakhnova TA, Blinova EV, Belevskaya AA, et al. Comparison of the integral indices of the vectorcardiogram with the data of echocardiography in patients with idiopathic and chronic thromboembolic pulmonary hypertension. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(3):11-6 (in Russian). DOI:10.26442/00403660.2019.03.000043
53. Sakhnova TA, Blinova EV, Yurasova ES, et al. Features of vectorcardiograms in patients with hypertension complicated by chronic heart failure with reduced left ventricle ejection fraction. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1067-71 (in Russian). DOI:10.26442/00403660.2022.09.201843
54. Sakhnova TA, Blinova EV, Dotsenko YV, et al. Detection of left ventricular systolic dysfunction in patients with ischemic heart disease using spatial and frontal QRS-T angles of the electrocardiogram. Terapevticheskii Arkhiv (Ter. Arkh.). 2024;96(4):337-41 (in Russian). DOI:10.26442/00403660.2024.04.202695
55. Chen J, Lin Y, Yu J, et al. Changes of virtual planar QRS and T vectors derived from holter in the populations with and without diabetes mellitus. Ann Noninvasive Electrocardiol. 2016;21(1):69-81. DOI:10.1111/anec.12276
2. Einthoven W, Fahr G, de Waart A. Über die Richtung und die manifeste Grösse der Potentialschwankungen im menschlichen Herzen und über den Einfluss der Herzlage auf die Form des Elektrokardiogramms. Pflugers Arch ges Physiol. 1913;150:275-315.
3. Mann H. А method of analyzing the electrocardiogram. Arch Intern Med (Chic). 1920;25(3):283-94.
4. Burch GE. The history of vectorcardiography. Med Hist Suppl. 1985;(5):103-31. PMID:3915520
5. Wilson FN, Macleod AG, Barker PS, Johnston FD. The determination and the significance of the areas of the ventricular deflections of the electrocardiogram. Am Heart J. 1934;10(1):46-61.
6. Wilson FN, MacLeod AG, Barker PS. The T deflection of the electrocardiogram. Trans Assoc Am Physicians. 1931;46:29-38.
7. Grishman A, Borun ER, Jaffe HL. Spatial vectorcardiography: Technique for the simultaneous recording of the frontal, sagittal, and horizontal projections. Am Heart J. 1951;41(4):483-93. PMID:14818957
8. Milnor WR, Talbot SA, Newman EV. A study of the relationship between unipolar leads and spatial vectorcardiograms, using the panoramic vectorcardiograph. Circulation. 1953;7(4):545-57. PMID:13033081
9. Frank E. An accurate, clinically practical system for spatial vectorcardiography. Circulation. 1956;13(5):737-49. PMID:13356432
10. Burch GE, Abildskov AA, Cronvich JA. A study of the spatial vectorcardiogram of the ventricular gradient. Circulation. 1954;9(2):267-75. PMID:13127188
11. Simonson E, Schmitt OH, Dahl J, et al. The theoretical and experimental bases of the frontal plane ventricular gradient and its spatial counterpart. Am Heart J. 1954;47(1):122-53. PMID:13114180
12. Burger HC. A theoretical elucidation of the notion ventricular gradient. Am Heart J. 1957;53(2):240-6. PMID:13394523
13. Gardberg M, Rosen IL. Monophasic curve analysis and the ventricular gradient in the electrogram of strips of turtle ventricle. Circ Res. 1959;7:870-5. PMID:13826483
14. Lux RL, Urie PM, Burgess MJ, Abildskov JA. Variability of the body surface distributions of QRS, ST-T and QRST deflection areas with varied activation sequence in dogs. Cardiovasc Res. 1980;14(10):607-12. PMID:7214395
15. Sridharan MR, Horan LG, Hand RC, et al. The determination of the human ventricular gradient from body surface potential map data. J Electrocardiol. 1981;14(4):399-406. PMID:7299310
16. Geselowitz DB. The ventricular gradient revisited: Relation to the area under the action potential. IEEE Trans Biomed Eng. 1983;30(1):76-7. PMID:6826192
17. Юрасова Е.С., Блинова Е.В., Сахнова Т.А. К истории векторкардиографии: прошлое, настоящее, будущее. Терапевтический архив. 2022;94(9):1122-5 [Yurasova ES, Blinova EV, Sakhnova TA. On the history of vectorcardiography: Past, present, future. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1122-5 (in Russian)]. DOI:10.26442/00403660.2022.09.201841
18. Vondrak J, Penhaker M. Review of processing pathological vectorcardiographic records for the detection of heart disease. Front Physiol. 2022;13:856590. DOI:10.3389/fphys.2022.856590
19. Prenner SB, Shah SJ, Goldberger JJ, Sauer AJ. Repolarization heterogeneity: Beyond the QT interval. J Am Heart Assoc. 2016;5(5):e003607. DOI:10.1161/JAHA.116.003607
20. Draisma HH, Schalij MJ, van der Wall EE, Swenne CA. Elucidation of the spatial ventricular gradient and its link with dispersion of repolarization. Heart Rhythm. 2006;3(9):1092-9. DOI:10.1016/j.hrthm.2006.05.025
21. Hurst JW. Thoughts about the ventricular gradient and its current clinical use (part II of II). Clin Cardiol. 2005;28(5):219-24. DOI:10.1002/clc.4960280504
22. Waks JW, Tereshchenko LG. Global electrical heterogeneity: A review of the spatial ventricular gradient. J Electrocardiol. 2016;49(6):824-30. DOI:10.1016/j.jelectrocard.2016.07.025
23. Tereshchenko LG. Global electrical heterogeneity: Mechanisms and clinical significance. Comput Cardiol (2010). 2018;45:10.22489/cinc.2018.165. DOI:10.22489/cinc.2018.165
24. Kors JA, Kardys I, van der Meer IM, et al. Spatial QRS-T angle as a risk indicator of cardiac death in an elderly population. J Electrocardiol. 2003;36(Suppl.):113-4. DOI:10.1016/j.jelectrocard.2003.09.033
25. Yamazaki T, Froelicher VF, Myers J, et al. Spatial QRS-T angle predicts cardiac death in a clinical population. Heart Rhythm. 2005;2(1):73-8. DOI:10.1016/j.hrthm.2004.10.040
26. Aro AL, Huikuri HV, Tikkanen JT, et al. QRS-T angle as a predictor of sudden cardiac death in a middle-aged general population. Europace. 2012;14(6):872-6. DOI:10.1093/europace/eur393
27. Zhang ZM, Prineas RJ, Case D, et al.; ARIC Research Group. Comparison of the prognostic significance of the electrocardiographic QRS/T angles in predicting incident coronary heart disease and total mortality (from the atherosclerosis risk in communities study). Am J Cardiol. 2007;100(5):844-9. DOI:10.1016/j.amjcard.2007.03.104
28. Блинова Е.В., Сахнова Т.А., Юрасова Е.С. Диагностическое и прогностическое значение угла QRS-T. Терапевтический архив. 2020;92(9):85-93 [Blinova EV, Sakhnova TA, Yurasova ES. Diagnostic and prognostic significance of QRS-T angle. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(9):85-93 (in Russian)]. DOI:10.26442/00403660.2020.09.000752
29. Tereshchenko LG, Cheng A, Fetics BJ, et al. Ventricular arrhythmia is predicted by sum absolute QRST integralbut not by QRS width. J Electrocardiol. 2010;43(6):548-52. DOI:10.1016/j.jelectrocard.2010.07.013
30. Tereshchenko LG, McNitt S, Han L, et al. ECG marker of adverse electrical remodeling post-myocardial infarction predicts outcomes in MADIT II study. PLoS One. 2012;7(12):e51812. DOI:10.1371/journal.pone.0051812
31. Sur S, Han L, Tereshchenko LG. Comparison of sum absolute QRST integral, and temporal variability in depolarization and repolarization, measured by dynamic vectorcardiography approach, in healthy men and women. PLoS One. 2013;8(2):e57175. DOI:10.1371/journal.pone.0057175
32. Pueyo E, Corrias A, Virág L, et al. A multiscale investigation of repolarization variability and its role in cardiac arrhythmogenesis. Biophys J. 2011;101(12):2892-902. DOI:10.1016/j.bpj.2011.09.060
33. Waks JW, Sitlani CM, Soliman EZ, et al. Global electric heterogeneity risk score for prediction of sudden cardiac death in the general population: The Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health (CHS) studies. Circulation. 2016;133(23):2222-34. DOI:10.1161/CIRCULATIONAHA.116.021306
34. Biering-Sørensen T, Kabir M, Waks JW, et al. Global ECG measures and cardiac structure and function: The ARIC Study (Atherosclerosis Risk in Communities). Circ Arrhythm Electrophysiol. 2018;11(3):e005961. DOI:10.1161/CIRCEP.117.005961
35. Tereshchenko LG, Feeny A, Shelton E, et al. Dynamic changes in high-sensitivity cardiac troponin I are associated with dynamic changes in sum absolute QRST integral on surface electrocardiogram in acute decompensated heart failure. Ann Noninvasive Electrocardiol. 2017;22(1):e12379. DOI:10.1111/anec.12379
36. Javed N, El-Far M, Vittorio TJ. Clinical markers in heart failure: A narrative review. J Int Med Res. 2024;52(5):3000605241254330. DOI:10.1177/03000605241254330
37. Perez-Alday EA, Bender A, German D, et al. Dynamic predictive accuracy of electrocardiographic biomarkers of sudden cardiac death within a survival framework: The Atherosclerosis Risk in Communities (ARIC) study. BMC Cardiovasc Disord. 2019;19(1):255. DOI:10.1186/s12872-019-1234-9
38. Fortune JD, Coppa NE, Haq KT, et al. Digitizing ECG image: A new method and open-source software code. Comput Methods Programs Biomed. 2022;221:106890. DOI:10.1016/j.cmpb.2022.106890
39. Haq KT, Lutz KJ, Peters KK, et al. Reproducibility of global electrical heterogeneity measurements on 12-lead ECG: The multi-ethnic study of atherosclerosis. J Electrocardiol. 2021;69:96-104. DOI:10.1016/j.jelectrocard.2021.09.014
40. Johnson JA, Haq KT, Lutz KJ, et al. Electrophysiological ventricular substrate of stroke: A prospective cohort study in the Atherosclerosis Risk in Communities (ARIC) study. BMJ Open. 2021;11(9):e048542. DOI:10.1136/bmjopen-2020-048542
41. Haq KT, Cao J, Tereshchenko LG. Characteristics of cardiac memory in patients with implanted cardioverter-defibrillators: The Cardiac Memory with Implantable Cardioverter-defibrillator (CAMI) study. J Innov Card Rhythm Manag. 2021;12(2):4395-408. DOI:10.19102/icrm.2021.120204
42. Stabenau HF, Shen C, Tereshchenko LG, et al. Changes in global electrical heterogeneity associated with dofetilide, quinidine, ranolazine, and verapamil. Heart Rhythm. 2020;17(3):460-7. DOI:10.1016/j.hrthm.2019.09.017
43. Peirlinck M, Sahli Costabal F, Kuhl E. Sex differences in drug-induced arrhythmogenesis. Front Physiol. 2021;12:708435. DOI:10.3389/fphys.2021.708435
44. Stabenau HF, Shen C, Zimetbaum P, et al. Global electrical heterogeneity associated with drug-induced torsades de pointes. Heart Rhythm. 2021;18(1):57-62. DOI:10.1016/j.hrthm.2020.07.038
45. Pollard JD, Haq KT, Lutz KJ, et al. Sex differences in vectorcardiogram of African-Americans with and without cardiovascular disease: A cross-sectional study in the Jackson Heart Study cohort. BMJ Open. 2021;11(1):e042899. DOI:10.1136/bmjopen-2020-042899
46. Howell SJ, German D, Bender A, et al. Does sex modify an association of electrophysiological substrate with sudden cardiac death? The Atherosclerosis Risk in Communities (ARIC) study. Cardiovasc Digit Health J. 2020;1(2):80-8. DOI:10.1016/j.cvdhj.2020.08.003
47. Jensen K, Howell SJ, Phan F, et al. Bringing critical race praxis into the study of electrophysiological substrate of sudden cardiac death: The ARIC study. Am Heart Assoc. 2020;9(3):e015012. DOI:10.1161/JAHA.119.015012
48. Jensen CJ, Zadeh B, Wambach JM, et al. Association of QRS-T angle and late gadolinium enhancement in patients with a clinical suspicion of myocarditis. Int J Med Sci. 2021;18(13):2905-9. DOI:10.7150/ijms.57010
49. Zadeh B, Wambach JM, Lambers M, et al. QRS-T-angle in patients with ST-segment Elevation Myocardial Infarction (STEMI) – A comparison with cardiac magnetic resonance imaging. Int J Med Sci. 2020;17(15):2264-8. DOI:10.7150/ijms.44312
50. Jensen CJ, Lambers M, Zadeh B, et al. QRS-T angle in patients with hypertrophic cardiomyopathy – A comparison with cardiac magnetic resonance imaging. Int J Med Sci. 2021;18(3):821-5. DOI:10.7150/ijms.52415
51. Stabenau HF, Marcus M, Matos JD, et al. The spatial ventricular gradient is associated with adverse outcomes in acute pulmonary embolism. Ann Noninvasive Electrocardiol. 2023;28(3):e13041. DOI:10.1111/anec.13041
52. Сахнова Т.А., Блинова Е.В., Белевская А.А., и др. Сопоставление интегральных показателей векторкардиограммы с данными эхокардиографического исследования у больных идиопатической и хронической тромбоэмболической легочной гипертензией. Терапевтический архив. 2019;91(3):11-6 [Sakhnova TA, Blinova EV, Belevskaya AA, et al. Comparison of the integral indices of the vectorcardiogram with the data of echocardiography in patients with idiopathic and chronic thromboembolic pulmonary hypertension. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(3):11-6 (in Russian)]. DOI:10.26442/00403660.2019.03.000043
53. Сахнова Т.А., Блинова Е.В., Юрасова Е.С., и др. Особенности векторкардиограмм у больных гипертонической болезнью, осложненной хронической сердечной недостаточностью со сниженной фракцией выброса левого желудочка. Терапевтический архив. 2022;94(9):1067-71 [Sakhnova TA, Blinova EV, Yurasova ES, et al. Features of vectorcardiograms in patients with hypertension complicated by chronic heart failure with reduced left ventricle ejection fraction. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1067-71 (in Russian)]. DOI:10.26442/00403660.2022.09.201843
54. Сахнова Т.А., Блинова Е.В., Доценко Ю.В., и др. Выявление систолической дисфункции левого желудочка у пациентов с ишемической болезнью сердца с помощью пространственного и фронтального углов QRS-T электрокардиограммы. Терапевтический архив. 2024;96(4):337-41 [Sakhnova TA, Blinova EV, Dotsenko YV, et al. Detection of left ventricular systolic dysfunction in patients with ischemic heart disease using spatial and frontal QRS-T angles of the electrocardiogram. Terapevticheskii Arkhiv (Ter. Arkh.). 2024;96(4):337-41 (in Russian)]. DOI:10.26442/00403660.2024.04.202695
55. Chen J, Lin Y, Yu J, et al. Changes of virtual planar QRS and T vectors derived from holter in the populations with and without diabetes mellitus. Ann Noninvasive Electrocardiol. 2016;21(1):69-81. DOI:10.1111/anec.12276
________________________________________________
2. Einthoven W, Fahr G, de Waart A. Über die Richtung und die manifeste Grösse der Potentialschwankungen im menschlichen Herzen und über den Einfluss der Herzlage auf die Form des Elektrokardiogramms. Pflugers Arch ges Physiol. 1913;150:275-315.
3. Mann H. А method of analyzing the electrocardiogram. Arch Intern Med (Chic). 1920;25(3):283-94.
4. Burch GE. The history of vectorcardiography. Med Hist Suppl. 1985;(5):103-31. PMID:3915520
5. Wilson FN, Macleod AG, Barker PS, Johnston FD. The determination and the significance of the areas of the ventricular deflections of the electrocardiogram. Am Heart J. 1934;10(1):46-61.
6. Wilson FN, MacLeod AG, Barker PS. The T deflection of the electrocardiogram. Trans Assoc Am Physicians. 1931;46:29-38.
7. Grishman A, Borun ER, Jaffe HL. Spatial vectorcardiography: Technique for the simultaneous recording of the frontal, sagittal, and horizontal projections. Am Heart J. 1951;41(4):483-93. PMID:14818957
8. Milnor WR, Talbot SA, Newman EV. A study of the relationship between unipolar leads and spatial vectorcardiograms, using the panoramic vectorcardiograph. Circulation. 1953;7(4):545-57. PMID:13033081
9. Frank E. An accurate, clinically practical system for spatial vectorcardiography. Circulation. 1956;13(5):737-49. PMID:13356432
10. Burch GE, Abildskov AA, Cronvich JA. A study of the spatial vectorcardiogram of the ventricular gradient. Circulation. 1954;9(2):267-75. PMID:13127188
11. Simonson E, Schmitt OH, Dahl J, et al. The theoretical and experimental bases of the frontal plane ventricular gradient and its spatial counterpart. Am Heart J. 1954;47(1):122-53. PMID:13114180
12. Burger HC. A theoretical elucidation of the notion ventricular gradient. Am Heart J. 1957;53(2):240-6. PMID:13394523
13. Gardberg M, Rosen IL. Monophasic curve analysis and the ventricular gradient in the electrogram of strips of turtle ventricle. Circ Res. 1959;7:870-5. PMID:13826483
14. Lux RL, Urie PM, Burgess MJ, Abildskov JA. Variability of the body surface distributions of QRS, ST-T and QRST deflection areas with varied activation sequence in dogs. Cardiovasc Res. 1980;14(10):607-12. PMID:7214395
15. Sridharan MR, Horan LG, Hand RC, et al. The determination of the human ventricular gradient from body surface potential map data. J Electrocardiol. 1981;14(4):399-406. PMID:7299310
16. Geselowitz DB. The ventricular gradient revisited: Relation to the area under the action potential. IEEE Trans Biomed Eng. 1983;30(1):76-7. PMID:6826192
17. Yurasova ES, Blinova EV, Sakhnova TA. On the history of vectorcardiography: Past, present, future. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1122-5 (in Russian). DOI:10.26442/00403660.2022.09.201841
18. Vondrak J, Penhaker M. Review of processing pathological vectorcardiographic records for the detection of heart disease. Front Physiol. 2022;13:856590. DOI:10.3389/fphys.2022.856590
19. Prenner SB, Shah SJ, Goldberger JJ, Sauer AJ. Repolarization heterogeneity: Beyond the QT interval. J Am Heart Assoc. 2016;5(5):e003607. DOI:10.1161/JAHA.116.003607
20. Draisma HH, Schalij MJ, van der Wall EE, Swenne CA. Elucidation of the spatial ventricular gradient and its link with dispersion of repolarization. Heart Rhythm. 2006;3(9):1092-9. DOI:10.1016/j.hrthm.2006.05.025
21. Hurst JW. Thoughts about the ventricular gradient and its current clinical use (part II of II). Clin Cardiol. 2005;28(5):219-24. DOI:10.1002/clc.4960280504
22. Waks JW, Tereshchenko LG. Global electrical heterogeneity: A review of the spatial ventricular gradient. J Electrocardiol. 2016;49(6):824-30. DOI:10.1016/j.jelectrocard.2016.07.025
23. Tereshchenko LG. Global electrical heterogeneity: Mechanisms and clinical significance. Comput Cardiol (2010). 2018;45:10.22489/cinc.2018.165. DOI:10.22489/cinc.2018.165
24. Kors JA, Kardys I, van der Meer IM, et al. Spatial QRS-T angle as a risk indicator of cardiac death in an elderly population. J Electrocardiol. 2003;36(Suppl.):113-4. DOI:10.1016/j.jelectrocard.2003.09.033
25. Yamazaki T, Froelicher VF, Myers J, et al. Spatial QRS-T angle predicts cardiac death in a clinical population. Heart Rhythm. 2005;2(1):73-8. DOI:10.1016/j.hrthm.2004.10.040
26. Aro AL, Huikuri HV, Tikkanen JT, et al. QRS-T angle as a predictor of sudden cardiac death in a middle-aged general population. Europace. 2012;14(6):872-6. DOI:10.1093/europace/eur393
27. Zhang ZM, Prineas RJ, Case D, et al.; ARIC Research Group. Comparison of the prognostic significance of the electrocardiographic QRS/T angles in predicting incident coronary heart disease and total mortality (from the atherosclerosis risk in communities study). Am J Cardiol. 2007;100(5):844-9. DOI:10.1016/j.amjcard.2007.03.104
28. Blinova EV, Sakhnova TA, Yurasova ES. Diagnostic and prognostic significance of QRS-T angle. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(9):85-93 (in Russian). DOI:10.26442/00403660.2020.09.000752
29. Tereshchenko LG, Cheng A, Fetics BJ, et al. Ventricular arrhythmia is predicted by sum absolute QRST integralbut not by QRS width. J Electrocardiol. 2010;43(6):548-52. DOI:10.1016/j.jelectrocard.2010.07.013
30. Tereshchenko LG, McNitt S, Han L, et al. ECG marker of adverse electrical remodeling post-myocardial infarction predicts outcomes in MADIT II study. PLoS One. 2012;7(12):e51812. DOI:10.1371/journal.pone.0051812
31. Sur S, Han L, Tereshchenko LG. Comparison of sum absolute QRST integral, and temporal variability in depolarization and repolarization, measured by dynamic vectorcardiography approach, in healthy men and women. PLoS One. 2013;8(2):e57175. DOI:10.1371/journal.pone.0057175
32. Pueyo E, Corrias A, Virág L, et al. A multiscale investigation of repolarization variability and its role in cardiac arrhythmogenesis. Biophys J. 2011;101(12):2892-902. DOI:10.1016/j.bpj.2011.09.060
33. Waks JW, Sitlani CM, Soliman EZ, et al. Global electric heterogeneity risk score for prediction of sudden cardiac death in the general population: The Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health (CHS) studies. Circulation. 2016;133(23):2222-34. DOI:10.1161/CIRCULATIONAHA.116.021306
34. Biering-Sørensen T, Kabir M, Waks JW, et al. Global ECG measures and cardiac structure and function: The ARIC Study (Atherosclerosis Risk in Communities). Circ Arrhythm Electrophysiol. 2018;11(3):e005961. DOI:10.1161/CIRCEP.117.005961
35. Tereshchenko LG, Feeny A, Shelton E, et al. Dynamic changes in high-sensitivity cardiac troponin I are associated with dynamic changes in sum absolute QRST integral on surface electrocardiogram in acute decompensated heart failure. Ann Noninvasive Electrocardiol. 2017;22(1):e12379. DOI:10.1111/anec.12379
36. Javed N, El-Far M, Vittorio TJ. Clinical markers in heart failure: A narrative review. J Int Med Res. 2024;52(5):3000605241254330. DOI:10.1177/03000605241254330
37. Perez-Alday EA, Bender A, German D, et al. Dynamic predictive accuracy of electrocardiographic biomarkers of sudden cardiac death within a survival framework: The Atherosclerosis Risk in Communities (ARIC) study. BMC Cardiovasc Disord. 2019;19(1):255. DOI:10.1186/s12872-019-1234-9
38. Fortune JD, Coppa NE, Haq KT, et al. Digitizing ECG image: A new method and open-source software code. Comput Methods Programs Biomed. 2022;221:106890. DOI:10.1016/j.cmpb.2022.106890
39. Haq KT, Lutz KJ, Peters KK, et al. Reproducibility of global electrical heterogeneity measurements on 12-lead ECG: The multi-ethnic study of atherosclerosis. J Electrocardiol. 2021;69:96-104. DOI:10.1016/j.jelectrocard.2021.09.014
40. Johnson JA, Haq KT, Lutz KJ, et al. Electrophysiological ventricular substrate of stroke: A prospective cohort study in the Atherosclerosis Risk in Communities (ARIC) study. BMJ Open. 2021;11(9):e048542. DOI:10.1136/bmjopen-2020-048542
41. Haq KT, Cao J, Tereshchenko LG. Characteristics of cardiac memory in patients with implanted cardioverter-defibrillators: The Cardiac Memory with Implantable Cardioverter-defibrillator (CAMI) study. J Innov Card Rhythm Manag. 2021;12(2):4395-408. DOI:10.19102/icrm.2021.120204
42. Stabenau HF, Shen C, Tereshchenko LG, et al. Changes in global electrical heterogeneity associated with dofetilide, quinidine, ranolazine, and verapamil. Heart Rhythm. 2020;17(3):460-7. DOI:10.1016/j.hrthm.2019.09.017
43. Peirlinck M, Sahli Costabal F, Kuhl E. Sex differences in drug-induced arrhythmogenesis. Front Physiol. 2021;12:708435. DOI:10.3389/fphys.2021.708435
44. Stabenau HF, Shen C, Zimetbaum P, et al. Global electrical heterogeneity associated with drug-induced torsades de pointes. Heart Rhythm. 2021;18(1):57-62. DOI:10.1016/j.hrthm.2020.07.038
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Авторы
В.Э. Олейников*, А.А. Чернова
ФГБОУ ВО «Пензенский государственный университет», Пенза, Россия
*v.oleynikof@gmail.com
Penza State University, Penza, Russia
*v.oleynikof@gmail.com
ФГБОУ ВО «Пензенский государственный университет», Пенза, Россия
*v.oleynikof@gmail.com
________________________________________________
Penza State University, Penza, Russia
*v.oleynikof@gmail.com
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