INTRAVENTRICULAR ELECTROCARDIOGRAPHIC STUDY ON RIGHT VENTRICULAR HYPERTROPHY ESPECIALLY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

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概要

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• At right heart catheterization, a catheter with a platinum electrode was used for recording bipolar electrocardiograms between each of the outflow tract, mid and inflow tract of the right ventricle and precordium. In the individual clinical cases including those of chronic obstructive pulmonary disease, the ratio right ventrcular element to left ventricular element was calculated, which anther named A ratio. Whether or not there was right ventricular predominance was examined by employing the A ratio as the index. Examination for correlationship was made between the A ratio, pulmonary arterial mean pressure (PAm) and cardiac index (CI), and the following conclusions have been obtained. 1) At the right ventricular outflow tract or mid, between the pulmonary arterial mean pressure and A ratio there was observed an significant positive correlationship (outflow, P<0.02; mid, p<0.01). In all but one of the cases whose pulmonary arterial mean pressure exceeded 17 mmHg, the A ratio at the outflow tract or mid was over 0.9. Dividing the cases into two groups, one showing over 0.9 as the A ratio at the right ventricular outflow tract or mid the other under 0.9, the T test, too, a difference of statistical significance (p<0.01) was observed between two groups. Thus, the A ratio has become known as an useful critical value for judgment whether or not there is pulmonary hypertension and/or right ventricular systolic overloading. 2) The A ratio at the right ventricular inflow tract exhibits a postive correlationship (p<0.02) with cardiac index. Especially in the cases of congenital heart disease accompanied by left to right shunt that pulmonary blood flow increased, the A ratio at the inflow tract tended distinctly to rise. 3) All the cases satisfied with the conventional electrocardiographic criteria for right ventricular hypertrophy (Roman et al. and WHO) showed the A ratio over 0.9. The increased A ratio may be interpreted to precede the right ventricular hypertrophy. The A ratio at the right ventricular outflow tract or mid seems to be useful as an index for early diagnosis of right ventricular hypertrophy. Increase in the A ratio at the outlfow tract or mid may be interpreted to represent the right ventricular overloading in not only cardiac disease but also chronic obstructive pulmonary disease, making it possible to evaluate to the aggravation from chronic obstructive pulmonary disease without pulmonary hypertension to chronic cor pulmonale.

• 社団法人日本循環器学会の論文
• 1973-06-20

著者

• Nomoto Kunihiro

  Department Of Internal Medicine Yamaguchi University School Of Medicine

• Nomoto Kunihiro

  Department Of Internal Medicine Shimane Medical University

関連論文

• JUGULAR PHLEBOGRAM IN PATIENTS WITH CHRONIC OBSTRUCTIVE LUNG DISEASE : PROCEEDINGS OF THE 38TH ANNUAL MEETING OF THE JAPANESE CIRCULATION SOCIETY
• Pulmonary Circulatory Disturbances in Pulmonary Hypertension with Special Reference to Pathophysiological Significances of Pulmonary Vascular Resistance Index
• INTRAVENTRICULAR ELECTROCARDIOGRAPHIC STUDY ON RIGHT VENTRICULAR HYPERTROPHY ESPECIALLY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
• Studies of Electrocardiographic Diagnosis of Right Ventricular Hypertrophy and of the Incidence of Arrhythmias and Left Ventricular Abnormalities in Patients with Chronic Obstructive Pulmonary Disease with Moderate to Severe Pulmonary Hypertension
• Continuous 24 Hour Electrocardiographic Study of Geriatric Patients without Cardio-Pulmonary Disease

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