Abstract
In order to evaluate ventricular failure in acute myocardial infarction, electrocardiographic left atrial overloading was correlated to several simultaneous clinical and radiological signs of left ventricular dysfunction in 200 consecutive patients. Analyses were made at three time periods after infarction. Left atrial overloading, measured by P terminal force, was significantly associated with the signs of left ventricular dysfunction, though in this unselected series of infarctions the prevalence of abnormal values was not high (46%). This finding is to be considered rather as a contributory sign than as a diagnostic one in the entire clinical picture. In an individual patient, however, conspicuous serial changes are helpful in indicating the direction of course of the haemodynamic disorder. The prognostic value of the P terminal force was found to be significant.
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- FREUNDLICH J., SERENO L. R. Auricular infarction. Am Heart J. 1959 May;57(5):654–660. doi: 10.1016/0002-8703(59)90174-7. [DOI] [PubMed] [Google Scholar]
- Fluck D. C., Valentine P. A., Treister B., Higgs B., Reid D. N., Steiner R. E., Mounsey J. P. Right heart pressures in acute myocardial infarction. Br Heart J. 1967 Sep;29(5):748–757. doi: 10.1136/hrt.29.5.748. [DOI] [PMC free article] [PubMed] [Google Scholar]
- GOLDBLATT A., AYGEN M. M., BRAUNWALD E. Hemodynamic-phonocardiographic correlations of the fourth heart sound in aortic stenosis. Circulation. 1962 Jul;26:92–98. doi: 10.1161/01.cir.26.1.92. [DOI] [PubMed] [Google Scholar]
- Gooch A. S., Calatayud J. B., Rogers J. B., Gorman P. A. Analysis of the P wave in severe aortic stenosis. Dis Chest. 1966 May;49(5):459–463. doi: 10.1378/chest.49.5.459. [DOI] [PubMed] [Google Scholar]
- Grossman J. I., Delman A. J. Serial P wave changes in acute myocardial infarction. Am Heart J. 1969 Mar;77(3):336–341. doi: 10.1016/0002-8703(69)90189-6. [DOI] [PubMed] [Google Scholar]
- Hawley R. R., Dodge H. T., Graham T. P. Left atrial volume and its changes in heart disease. Circulation. 1966 Dec;34(6):989–996. doi: 10.1161/01.cir.34.6.989. [DOI] [PubMed] [Google Scholar]
- Kasser I., Kennedy J. W. The relationship of increased left atrial volume and pressure to abnormal P waves on the electrocardiogram. Circulation. 1969 Mar;39(3):339–343. doi: 10.1161/01.cir.39.3.339. [DOI] [PubMed] [Google Scholar]
- LIU C. K., GREENSPAN G., PICCIRILLO R. T. Atrial infarction of the heart. Circulation. 1961 Mar;23:331–338. doi: 10.1161/01.cir.23.3.331. [DOI] [PubMed] [Google Scholar]
- MIORI R., MAZZEI G. IL QUADRO ELETTROCARDIOGRAFICO DI INGRANDIMENTO ATRIALE SINISTRO IN CORSO DI INFARTO MIOCARDICO E IL SUO SIGNIFICATO. Minerva Cardioangiol. 1965 Feb;13:65–70. [PubMed] [Google Scholar]
- MORRIS J. J., Jr, ESTES E. H., Jr, WHALEN R. E., THOMPSON H. K., Jr, MCINTOSH H. D. P-WAVE ANALYSIS IN VALVULAR HEART DISEASE. Circulation. 1964 Feb;29:242–252. doi: 10.1161/01.cir.29.2.242. [DOI] [PubMed] [Google Scholar]
- NAGER F., KAUFMANN G., SCHAUB F. DIE LEISTUNGSFAEHIGKEIT MECHANOKARDIOGRAPHISCHER UNTERSUCHUNGEN IN DER ERFASSUNG DER MITRALINSUFFIZIENZ UND IHRES SCHWEREGRADES UNTER BESONDERER BERUECKSICHTIGUNG DER KOMBINIERTEN MITRALVITIEN. Cardiologia. 1964;44:218–232. [PubMed] [Google Scholar]
- PENNEYS R., THOMAS C. B. The relationship between the arterial oxygen saturation and the cardiovascular response to induced anoxemia in normal young adults. Circulation. 1950 Mar;1(3):415–425. doi: 10.1161/01.cir.1.3.415. [DOI] [PubMed] [Google Scholar]
- REYNOLDS G. The atrial electrogram in mitral stenosis. Br Heart J. 1953 Apr;15(2):250–258. doi: 10.1136/hrt.15.2.250. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Raftery E. B., Oakley C. M., Goodwin J. F. Acute subvalvar mitral incompetence. Lancet. 1966 Aug 13;2(7459):360–365. doi: 10.1016/s0140-6736(66)92659-6. [DOI] [PubMed] [Google Scholar]
- Roughgarden J. W. Circulatory changes associated with spontaneous angina pectoris. Am J Med. 1966 Dec;41(6):947–961. doi: 10.1016/0002-9343(66)90052-0. [DOI] [PubMed] [Google Scholar]
- SCHMIDT J., HILMER W. Untersuchungen über die P-Zacke des Elektrokardiogramms. I. Das P-sinsitro-cardiale. Z Kreislaufforsch. 1951 May;40(9-10):275–292. [PubMed] [Google Scholar]
- SUH S. K., EDDLEMAN E. E., Jr Kinetocardiographic findings of myocardial infarction. Circulation. 1959 Apr;19(4):531–542. doi: 10.1161/01.cir.19.4.531. [DOI] [PubMed] [Google Scholar]
- SUTNICK A. I., SOLOFF L. A. Posterior rotation of the atrial vector. An electrocardiographic sign of left ventricular failure. Circulation. 1962 Nov;26:913–916. doi: 10.1161/01.cir.26.5.913. [DOI] [PubMed] [Google Scholar]
- Saunders J. L., Calatayud J. B., Schulz K. J., Maranhao V., Gooch A. S., Goldberg H. Evaluation of ECG criteria for P-wave abnormalities. Am Heart J. 1967 Dec;74(6):757–765. doi: 10.1016/0002-8703(67)90095-6. [DOI] [PubMed] [Google Scholar]
- Sitar J. The clinical significance of the P-sinistrocardiale in left ventricular myocardial infarctions. Cor Vasa. 1965;7(4):301–310. [PubMed] [Google Scholar]
- Tarazi R. C., Frohlich E. D., Dustan H. P. Left atrial abnormality and ventricular preejection period in hypertension. Dis Chest. 1969 Mar;55(3):214–218. doi: 10.1378/chest.55.3.214. [DOI] [PubMed] [Google Scholar]
- Tattersfield A. E., McNicol M. W., Shawdon H., Rolfe D. Chest x-ray film in acute myocardial infarction. Br Med J. 1969 Aug 9;3(5666):332–335. doi: 10.1136/bmj.3.5666.332. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Valori C., Thomas M., Shillingford J. P. Urinary excretion of free noradrenaline and adrenaline following acute myocardial infarction. Lancet. 1967 Jan 21;1(7482):127–130. doi: 10.1016/s0140-6736(67)91033-1. [DOI] [PubMed] [Google Scholar]