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British Heart Journal logoLink to British Heart Journal
. 1984 Nov;52(5):516–523. doi: 10.1136/hrt.52.5.516

Relation between electrocardiographic repolarisation changes and mechanical events in left ventricular hypertrophy.

R B Moore, L M Shapiro, D G Gibson
PMCID: PMC481674  PMID: 6238612

Abstract

The relation between ventricular function and the presence of electrocardiographic "strain" in patients with left ventricular hypertrophy was examined using digitised M mode echocardiography and 12 lead electrocardiograms in 64 patients with pressure overload, 21 with hypertrophic cardiomyopathy, and 14 athletes. Although all had increased left ventricular mass, those with strain had a prolonged interval from minimum cavity dimension to mitral valve opening and a reduced rate of early diastolic posterior wall thinning and dimension increase compared with those with normal ST segments and T waves. Both groups had normal systolic function (fractional shortening and peak velocity of circumferential fibre shortening), and the time between the termination of the T wave and minimum dimension was similar. In athletes, however, electromechanical systole was shorter than normal, and the end of the T wave and minimum cavity dimension were synchronous. It is concluded that abnormal electrical recovery in left ventricular hypertrophy is closely related to impaired early relaxation and may be dissociated from impaired systolic function, cavity dimension, interventricular conduction delay, and the presence of increased mass alone. The normal relation between electrical and mechanical systole is preserved even when the polarity of repolarisation is reversed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Boudoulas H., Geleris P., Lewis R. P., Rittgers S. E. Linear relationship between electrical systole, mechanical systole, and heart rate. Chest. 1981 Nov;80(5):613–617. doi: 10.1378/chest.80.5.613. [DOI] [PubMed] [Google Scholar]
  2. Burgess M. J., Green L. S., Millar K., Wyatt R., Abildskov J. A. The sequence of normal ventricular recovery. Am Heart J. 1972 Nov;84(5):660–669. doi: 10.1016/0002-8703(72)90181-0. [DOI] [PubMed] [Google Scholar]
  3. Devereux R. B., Reichek N. Repolarization abnormalities of left ventricular hypertrophy. Clinical, echocardiographic and hemodynamic correlates. J Electrocardiol. 1982 Jan;15(1):47–53. doi: 10.1016/s0022-0736(82)80044-7. [DOI] [PubMed] [Google Scholar]
  4. Gibson D. G., Brown D. J. Abnormal left ventricular wall movement in patients with chest pain and normal coronary arteriograms. Relation to inferior T wave changes and mitral prolapse. Br Heart J. 1979 Apr;41(4):385–391. doi: 10.1136/hrt.41.4.385. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gibson D. G., Greenbaum R., Marier D. L., Brown D. J. Clinical significance of early diastolic changes in left ventricular wall thickness. Eur Heart J. 1980;Suppl A:157–163. doi: 10.1093/eurheartj/1.suppl_1.157. [DOI] [PubMed] [Google Scholar]
  6. Gibson D. G., Traill T. A., Hall R. J., Brown D. J. Echocardiographic features of secondary left ventricular hypertrophy. Br Heart J. 1979 Jan;41(1):54–59. doi: 10.1136/hrt.41.1.54. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Goodwin J. F. The frontiers of cardiomyopathy. Br Heart J. 1982 Jul;48(1):1–18. doi: 10.1136/hrt.48.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gould K. L., Lipscomb K., Hamilton G. W., Kennedy J. W. Left ventricular hypertrophy in coronary artery disease. A cardiomyopathy syndrome following myocardial infarction. Am J Med. 1973 Nov;55(5):595–601. doi: 10.1016/0002-9343(73)90180-0. [DOI] [PubMed] [Google Scholar]
  9. Grossman W., Jones D., McLaurin L. P. Wall stress and patterns of hypertrophy in the human left ventricle. J Clin Invest. 1975 Jul;56(1):56–64. doi: 10.1172/JCI108079. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Laurent G. J. Rates of collagen synthesis in lung, skin and muscle obtained in vivo by a simplified method using [3H]proline. Biochem J. 1982 Sep 15;206(3):535–544. doi: 10.1042/bj2060535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Marcus M. L., Doty D. B., Hiratzka L. F., Wright C. B., Eastham C. L. Decreased coronary reserve: a mechanism for angina pectoris in patients with aortic stenosis and normal coronary arteries. N Engl J Med. 1982 Nov 25;307(22):1362–1366. doi: 10.1056/NEJM198211253072202. [DOI] [PubMed] [Google Scholar]
  12. SELZER A., NARUSE D. Y., YORK E., KAHN K. A., MATTHEWS H. B. Electrocardiographic findings in concentric and eccentric left ventricular hypertrophy. Am Heart J. 1962 Mar;63:320–328. doi: 10.1016/0002-8703(62)90276-4. [DOI] [PubMed] [Google Scholar]
  13. Shapiro L. M., Moore R. B., Logan-Sinclair R. B., Gibson D. G. Relation of regional echo amplitude to left ventricular function and the electrocardiogram in left ventricular hypertrophy. Br Heart J. 1984 Jul;52(1):99–105. doi: 10.1136/hrt.52.1.99. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Shapiro L. M. Physiological left ventricular hypertrophy. Br Heart J. 1984 Aug;52(2):130–135. doi: 10.1136/hrt.52.2.130. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Sutton M. G., Tajik A. J., Gibson D. G., Brown D. J., Seward J. B., Guiliani E. R. Echocardiographic assessment of left ventricular filling and septal and posterior wall dynamics in idiopathic hypertrophic subaortic stenosis. Circulation. 1978 Mar;57(3):512–520. doi: 10.1161/01.cir.57.3.512. [DOI] [PubMed] [Google Scholar]
  16. Sutton M. G., Tajik A. J., Smith H. C., Ritman E. L. Angina in idiopathic hypertrophic subaortic stenosis. A clinical correlate of regional left ventricular dysfunction: a videometric and echocardiographic study. Circulation. 1980 Mar;61(3):561–568. doi: 10.1161/01.cir.61.3.561. [DOI] [PubMed] [Google Scholar]
  17. Upton M. T., Gibson D. G. The study of left ventricular function from digitized echocardiograms. Prog Cardiovasc Dis. 1978 Mar-Apr;20(5):359–384. doi: 10.1016/0033-0620(78)90003-8. [DOI] [PubMed] [Google Scholar]
  18. van DAM R., DURRER D. Experimental study on the intramural distribution of the excitability cycle and on the form of the epicardial T wave in the dog heart in situ. Am Heart J. 1961 Apr;61:537–542. doi: 10.1016/0002-8703(61)90554-3. [DOI] [PubMed] [Google Scholar]
  19. von Bibra H., Gibson D. G., Nityanandan K. Effects of propranolol on left ventricular wall movement in patients with ischaemic heart disease. Br Heart J. 1980 Mar;43(3):293–300. doi: 10.1136/hrt.43.3.293. [DOI] [PMC free article] [PubMed] [Google Scholar]

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