Document Detail


Repolarization abnormalities of left ventricular hypertrophy. Clinical, echocardiographic and hemodynamic correlates.
MedLine Citation:
PMID:  6461707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the clinical significance of ECG depolarization abnormalities of left ventricular hypertrophy, ECG findings were related to echocardiographic or autopsy left ventricular mass, geometry and function as well as hemodynamic overload, in a heterogeneous population of 161 patients. ST depression and asymmetric T wave inversion were present in 21/107 patients not receiving digitalis (19%) and in 33/54 (61%) receiving digitalis. In patients not receiving digitalis their prevalence increased linearly from 0% (0/31) with LV mass less than or equal to 100 grams to 100% (8/8) with LV mass over 400 grams (p less than 0.001). Patients taking digitalis manifested "strain" commonly despite a normal LV mass (4/14, 28%), but even more frequently with an LV mass over 200 grams (27/40, 68%) (p less than 0.05). In the absence of digitalis, repolarization abnormalities were also significantly associated with a reduced ejection fraction (8/17 or 47% versus 8/83 or 10%; p less than 0.001), increased LV internal diameter (9/18 or 50% versus 12/89 or 13%; p less than 0.01), and systolic blood pressure over 140 mm Hg (9/29 or 31% versus 7/61 or 11%; p less than 0.05). Increased thickness of the LV wall was not significantly associated with LV "strain" (p = 0.1). In this population, LV "strain" alone performed as well as other single or combined ECG criteria in the recognition of LVH (sensitivity 52%, specificity 95%). Thus, in the absence of digitalis, repolarization abnormalities are a highly useful ECG sign of LVH, despite numerous other factors capable of causing indistinguishable abnormalities.
Authors:
R B Devereux; N Reichek
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  15     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  1982 Jan 
Date Detail:
Created Date:  1982-06-21     Completed Date:  1982-06-21     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  47-53     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cardiomegaly / physiopathology*
Digitalis Glycosides / therapeutic use
Echocardiography
Electrocardiography*
Female
Heart Catheterization
Heart Diseases / drug therapy,  physiopathology
Heart Ventricles / anatomy & histology,  pathology,  physiopathology*
Hemodynamics
Humans
Hypertension / drug therapy,  physiopathology
Male
Middle Aged
Stroke Volume
Systole
Chemical
Reg. No./Substance:
0/Digitalis Glycosides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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